By: 21 October 2013
The Burden of Hip Osteoarthritis in the United States: Epidemiologic and Economic Considerations: is osteoarthritis the new hip thing?

Shane J. Nho, MD, MS, et al.

The Burden of Hip Osteoarthritis in the United States: Epidemiologic and Economic Considerations. In Journal of the American Academy of Orthopaedic Surgeons. July 2013. Vol. 21. Supplement 1. Pp. S1-S6.


In 2003, 202,500 total hip replacements were carried out. In that same year, 36,000 total hip replacements were operated on again to revise, remove, or replace the first implant. The number of people between the ages of 30 and 65 who will develop osteoarthritis is expected to increase two to 10 times the current rate.

The pace at which the need for hip replacement is rising – estimated using hospital data from a national database – has taken the orthopaedic community by surprise. All previous estimates of future numbers of primary and revision total hip replacements have been way under par.

Not only are more adults being affected by osteoarthritis resulting in hip degeneration, but the age at which the need has occurred has declined; more and more under-55-year-olds are getting total hip replacements. And that trend is expected to continue into the future as well.

Besides typical direct medical costs of this, there are also indirect costs. These refer to lost wages, decreased productivity, and time spent in doctor offices. The cost of care from complementary or alternative care such as supplements, acupuncture, massages, and energy medicine must be factored in as well.

Finally, there are intangible effects and costs of hip osteoarthritis. The effects of pain, loss of motion, reduced function, and decreased quality of life have been measured.

Researchers asked patients how many years of life they would give up in exchange for a cure of their hip problems.

Not surprisingly, patients who have to pay out-of-pocket are less likely to give up years of life to be free of their symptoms.

With the trend toward increasing numbers of people with hip osteoarthritis severe enough to need (or want) an expensive hip replacement surgery, this type of social research will be important. Long-term results of hip replacement (including improvements in quality of life) at all ages will eventually be available.

Those outcomes may further confirm the need for early prevention and people’s willingness. This will especially be true for those individuals who have a condition known as femoroacetabular impingement (FAI). The shape of their hip from birth puts them at increased risk for degenerative disease later in life. With proper weight management and appropriate exercise this upward trend of osteoarthritis (with or without the impingement problem) may be slowed or possibly even halted.