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The Epidemiology of Joint Replacements Across Western Victoria, Australia: a Cross-sectional Study

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Abstract

Contemporary data are required to plan interventions and identify gaps in health service provision. As part of the larger Ageing, Chronic Disease and Injury study, we mapped joint replacements across the western region of the Australian state of Victoria. Primary total joint replacement data were extracted from the Australian Orthopaedic Association National Joint Replacement Registry for men and women aged ≥ 40 years during 2010–2013, inclusive. Crude and age-adjusted rates (per 10,000 population/year) of primary total joint replacements at the hip, knee and ‘other’ were determined for the entire region, and separately for each local government area (LGA). The reason and distance travelled for replacement were determined. Age-adjusted rates of joint replacements per 10,000 population/year in men and women (combined) were 39.3 (95% CI 37.9–40.6) for the hip, 42.2 (95% CI 40.8–43.6) for the knee and 3.7 (95% CI 3.3–4.1) for ‘other’ joint replacements. Age-adjusted incidence rates varied across rural LGAs. For residents of Ballarat, Greater Geelong and Warrnambool, most procedures (> 80%) were performed in the LGA of patient residence. For other LGAs, the percentage varied from 0 to 44.2%. Outside major population centres, the distance travelled ranged from 2.9 to 1111.0 km (median 97.5, IQR 61.2–190.0). Overall, rural LGAs had higher rates of joint replacements. Distance travelled for replacement procedures varied. The methods used in this study provide a model for similar research in rural environments, as well as providing important policy direction in the planning of health service provision across rural and regional communities.

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Acknowledgements

This study is funded by the Western Alliance Academic Health Science Centre, a partnership for research collaboration between Deakin University, Federation University and 13 health service providers operating across western Victoria. SLB-O and LJW are each supported by a NHMRC Career Development Fellowship (1107510 and 1064272, respectively). KLH-K is supported by an Alfred Deakin Postdoctoral Research Fellowship, Deakin University. MAS is supported by a Deakin University stipend via the IMPACT Strategic Research Centre. The funding sources had no impact on the study design, analysis or interpretation.

Funding

This study is funded by the Western Alliance Academic Health Science Centre, a partnership for research collaboration between Deakin University, Federation University and 13 health service providers operating across western Victoria. SLB-O and LJW are each supported by a NHMRC Career Development Fellowship (1107510 and 1064272, respectively). KLH-K is supported by an Alfred Deakin Postdoctoral Research Fellowship, Deakin University. MAS is supported by a Deakin University stipend via the IMPACT Strategic Research Centre. The funding sources had no impact on the study design, analysis or interpretation.

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Authors

Contributions

KLH-K, MAS, MAK and JAP conceived the study. JAP obtained research funding. KLH-K, AC, SG and RP contributed to the data collection. KLH-K, MAK and JAP were responsible for the data analyses. KLH-K drafted the manuscript, and all other authors contributed substantially to its revision. KLH-K takes responsibility for the paper as a whole.

Corresponding author

Correspondence to Kara L. Holloway-Kew.

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Conflict of Interest

SG is the Director of The Australian Orthopaedic Association National Joint Replacement Registry. KLH-K, MAS, MAK, AC, PML, MK, SH, TLD, SB, RSP, AS, SLB-O, LJW and JAP declare that they have no conflicts of interest.

Ethical Approval

The AOANJRR Data Review Committee approved access to National Joint Replacement Registry data for this study and the Barwon Health Human Research Ethics Committee approved this study (HREC 15/11).

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Holloway-Kew, K.L., Sajjad, M.A., Kotowicz, M.A. et al. The Epidemiology of Joint Replacements Across Western Victoria, Australia: a Cross-sectional Study. SN Compr. Clin. Med. 1, 1038–1047 (2019). https://doi.org/10.1007/s42399-019-00164-4

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