Table 1: Summary of Findings from Included Studies

Study Country Years Studied Population/Setting Type of Study Type Rate Age Standardized Registry-Based
Population-based studies of THA and TKA
1. Ingvarsson, 1999 [7] Iceland 1982-1996 Population-based Cohort THA for osteoarthritis (OA) 1996:
40-49 yrs: 17/100,000
50-59 yrs: 97/100,000
60-69 yrs: 333/100,000
70-79 yrs: 499/100,000
80+ yrs: 314/100,000		 Yes No
2. Lohmander 2006 [8] Denmark, Finland, Iceland, Norway, Sweden 1996-2000 Population-based Cohort Primary THA for primary hip OA All: 61-84/100,000
F: 60-92/100,000
M: 48-75/100,000		 Yes Yes
3. Pedersen 2005 [9] Denmark 1996-2002 Population-based Cohort Primary and revision THA Incidence rate, 1996:
Prim THA: 101/100,000
Rev THA: 19/100,000
Incidence rate, 2002:
Prim THA: 131/100,000
Rev THA: 21/100,000		 Yes Yes
4. Steel 2006 [10] U.K. 2002 Population-based: people ≥60 yrs, representative of the population of England interviewed Cross-sectional THA or TKA Lifetime prevalence of THA or TKA :
F: 6%
M: 5%		 No No
5. Robertsson 2000 [11] Sweden 1976-1997 Population-based Cohort primary and revision TKAs Incidence rate, 1976:
Prim TKA, all: 13/100,000
F: 18/100,000
M: 7/100,000
Incidence rate, 1997:
Prim TKA, all: 63/100,000
F: 69/100,000
M: 35/100,000		 Yes Yes
6. Coyte 1997 [12] Ontario, Canada 1984-1990 TKAs performed in Ontario from the Canadian Institute for Health Information Cohort TKA Utilization rates: 1984 to 1990
F: 24/100,000 to 52/100,000
M: 11/100,000 to 33/100,000		 Yes No
7. Melton 1982 [25] Olmsted County, U.S. 1969-1980 THAs performed in Olmsted county, Minnesota Cohort THA Biennial Incidence rates:
1969-1970: 20/100,000
1971-1972: 45/100,000
1973-74: 48/100,000
1975-76: 43/100,000
1977-78: 54/100,000
1979-80: 54/100,000
F: 52/100,000
M: 34/100,000		 Yes Yes
8. Johnsson 1987 [26] Southern Sweden 1981-82 THA in nine Southern most units in Sweden Cohorts THA Hip Replacement (THA and hemi-arthroplasty):
26/10,000 for adults aged 49 and older		 Yes Yes
9. Wells 2002 [13] Australia 1994-1998 Population-based: all Australians underwent THA
and TKA for the principal diagnosis of osteoarthritis		 Cohort THA and TKA for OA 1994: Prim THA: 51/100,000
Prim TKA: 56/100,000
1998: Prim THA: 61/100,000
Prim TKA: 77/100,000		 No No
Registry/National Database Based THA Studies
10. Abbott 2003 [14] U.S. 1995-1999 2000 United States Renal Data System Cohort THA 35 per 10,000 person-years compared to 5.3/10,000
in the general population		 No No
11. Clark 2001 [15] U.S. 1987-1996 Army aviators
214,300 aviator-years of observation		 Cohort THA 0.05/1,000 aviator years
of observation (11 aviators with 14 THAs)		 No Yes
12. Kim 2008 [16] South Korea 2002-2006 National Database with
reimbursement records from all South Korean medical facilities		 Cross-sectional THA 2002: F: 1.7/100,000
M: 1.4/100,000
2005: F: 3.1/100,000
M: 2/100,000		 Yes Yes
13. Birrell 1999 , [27] England 1996 Hospital Episode System
(HES) for identification of all THAs		 Cross-sectional THA 1996: All: 87/100,000
F: 109/100,000
M: 65/100,000		 No No
14. Hoaglund 1995 und,
F. T. [28]		 San Francisco, U.S. 1984-1988 Hospital records from 17
hospitals in “San Francisco country”		 Cross-sectional THA for primary hip OA White: 76/100,000
Black: 35/100,000
Hispanic: 13/100,000
Filipino: 7/100,000
Japanese: 17/100,000
Chinese: 8/100,000 		Yes No
15. Puolakka 2001 [29] Finland 1999 Cohort THA 1999: Prim THA: 93/100,000Rev THA: 23/100,000 No Yes
Registry/National Database Based TKA Studies
16. Mehrotra 2005 [17] U.S. 1990-2000 Wisconsin Inpatient Hospital Database for Wisconsin residents ≥45 years Cross-sectional Primary TKA 1990: All
(age-standardized): 162/100,00
F: 30/100,000
M: 23/100,000
2000: All (age-standardized): : 294/100,000
F: 46/100,000
M: 35/1000,000		 Yes No
17. Kim 2008 [18] South Korea 2002-2005 National Database with reimbursement records from all South Korean medical facilities Cross-sectional TKA 2002: F: 85/100,000
M: 10/100,000
2005: F: 157/100,000
M: 20/100,000		 Yes Yes
18. Juni 2003 [19] U.K. 1994-95 Survey of 40 clinical practices in Somerset and Avon, UK of 26,046 people Cross-Sectional TKA 8.4/1,000 for TKA for
subjects ≥35 years
M: 5.5/1,000
F: 10.7/1,000		 No No
19. Centers for Disease Control and Prevention 2009 [20] U.S. 2000 & 2006 Medicare enrollees aged
≥65 years, not members of Health Maintenance organizations and entitled
to Medicare part A
2000: 26,585,955
2006: 28,382,683		 Cross-sectional TKA 2000: 5.5/1,000
2006: 8.7/1,000
Racial Disparity:
Whites: 5.7/1,000 in 2000 and 9.2/1,000 in 2006
Blacks: 3.6/1,000 in 2000 and 5.6/1,000 in 2006
Male: 4.6 in 2000, 7.3 in 2006
Female: 6.1 in 2000, 9.8 in 2006		 Yes No
Registry/National Database Based THA and TKA Studies
20. Jarvholm 2007 [21] Sweden 1960-1992 Construction worker
cohort participating in national health control program from		 Cohort THA & TKA Ranged between
professions from 447-857/million person-years for THA, 123-407/million person-years for TKA		 Yes Yes
21. Kurtz 2007 [22] U.S. 1990-2002 National Hospital
Discharge Survey (NHDS), a representative sample of all non-federal
non-military in-patient facilities		 Cross-sectional THA and TKA 1990: Prim THA:
47/100,000
Rev THA: 9.5/100,000
Prim TKA: 51/100,000
Rev TKA: 4.7/100,000
2002: Prim THA: 69/100,000
Rev THA: 15.2/100,000
Prim TKA: 136/100,000
Rev TKA: 12.5/100,000		 Yes No
22. Melzer 2003 [23] U.S. 1993 1993 National
Mortality Follow back Survey in people ≥65 years, who had THA or TKA <1
year from their death		 Cross-sectional TKA and THA Prevalence:
THA: 15.5%
TKA: 6%		 No No
23. Wells 2004 [24] Australia 1994-2002 Male Veterans
compared with male civilians for THA and TKA for OA in Southern
Australia 		Cohort THA and TKA
for OA		 THA:
Standardized morbidity ratio (SMR)- 0.715
TKA: SMR-0.987		 Yes Yes
24. Havelin 2000 [30] Norway 1997 Norwegian register established 1988 Cohort THA 1997: prim THA:
120/100,000
Rev THA: 24/100,000
Prim TKA: 34/100,000

THA, Total Hip Arthroplasty; TKA, Total Knee Arthroplasty; OA, osteoarthritis, F, female; M, male; Prim, primary; Rev, revision.