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Rheumatology 2008 47(1):88-91; doi:10.1093/rheumatology/kem308
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© 2007 The Author(s)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

The epidemiology of total knee replacement in South Korea: national registry data

H.-A. Kim1, S. Kim1, Y. I. Seo1, H. J. Choi2, S.-C. Seong3, Y. W. Song3, D. Hunter4,5 and Y. Zhang5

1Hallym University Sacred Heart Hospital, Anyang, 2Gachon University of Medicine and Science, Incheon, 3Seoul National University Hospital, Seoul, South Korea, 4New England Baptist Hospital, Boston, MA and 5Boston University School of Medicine, Boston, MA, USA.

Correspondence to: H.-A. Kim, Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896, Pyongchondong, Dongan-gu, Anyang, Kyunggi-do 431-070, South Korea. E-mail: kimha{at}hallym.ac.kr


  Abstract

Objective. Knee osteoarthritis (OA) is prevalent among the elderly in Asian countries; however, the utilization of total knee replacement (TKR) is unknown. Using data from a national registry, we sought to estimate the incidence of TKR by age and sex, and the trend for TKR utilization from 2002 to 2005 in South Korea.

Methods. Reimbursement records from all hospitals in South Korea were extracted from the Health Insurance Review Agency (HIRA) database. Records with both the procedure code corresponding to a TKR and the diagnosis code of knee OA were selected. We estimated the age- and sex-specific rates of TKR. To compare the rate of TKR between men and women, we calculated age-standardized risk ratios. A TKR registry from a single centre containing more clinical information was analysed, and the differences in the clinical features between men and women were compared.

Results. From 2002 to 2005, 47 961 TKRs were performed in subjects over the age of 40 yrs due to OA. The rate of TKR has increased over the 4 yrs and was much higher in women than in men. Compared with men, the age-standardized rate ratios for TKR in women ranged from 7.4 to 8.0. The single-centre registry data revealed that there was no difference in age, disease duration and the Kellgren–Lawrence grade at the time of surgery between men and women.

Conclusion. Using a national database, we found that the rate of TKR increased steadily from 2002 to 2005 in South Korea. The TKR rate in women was much higher than that in men. Risk factors that account for such disparity in TKR utilization need to be further investigated.

KEY WORDS: Osteoarthritis, Total knee replacement, Sex difference, Epidemiology

Submitted 1 August 2007; revised version accepted 17 October 2007.
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