National Joint Registry Data Reveal Disparities In The Provision Of Hip And Knee Replacement Surgery



National Joint Registry Data Reveal Disparities In The Provision Of Hip And Knee Replacement Surgery

Share on facebook
Share on twitter
Share on linkedin
Share on whatsapp

As per research published in PLOS Medicine, knee and hip replacements are examples of elective orthopedic operations often performed to ease the discomfort caused by severe osteoarthritis in the knee or hip. These operations are effective and affordable in lowering suffering and recovering lost mobility. However, it is general knowledge that there are discrepancies and inequities in the provision of these surgeries, notably for older patients, female patients, and persons living in economically challenged areas.

The National Health Service (NHS) in the United Kingdom has been under increasing strain in recent years due to an aging and overweight population and slow treatment capacity improvement. In addition, due to the current economic crisis, the National Health Service (NHS) and hospital funding have both been curtailed, which has led to the shift of patients from the NHS to the private sector.  

A large national dataset of people who had primary hip and knee replacement surgery revealed socioeconomic inequalities. According to the data, the wealthiest and poorest neighborhoods have remained essentially the same over the years, which is valid for both sexes. When the impacts of social deprivation were split down by gender, researchers discovered that the patterns of IMD deprivation for both hip and knee replacements were the same.

There was evidence of disparities in publicly and privately financed hip replacement procedures; however, variations in social deprivation were only observed in privately funded knee replacement surgeries. This was true even though hip replacement surgery was both government and privately funded. When the data was broken down according to age, it was revealed that the discrepancy in the IMD deprivation group for hip replacement was higher in the over-70 age group than in the under-70 age group.  

Even though taxpayer dollars pay for it, the National Health Service (NHS) contracts out part of its orthopedic services. Data collected over ten years showed that those living in the poorest communities have the most demand for surgical care. This study discovered significant socioeconomic inequalities between government-funded and privately supported hip surgeries. On the other hand, there was no indication of significant socioeconomic disparities in access to publicly supported knee replacements.  

One of the study’s most prominent strengths was the inclusion of a large obligatory national dataset, which comprised information from about 95% of all of these procedures. The NJR used to record surgical procedures for patients at NHS and private hospitals and private treatment facilities, has very high data completion and accuracy rates.

The NJR was used to record surgical procedures for patients at private-sector treatment institutions. The analysis encompassed a time that contained the publishing of the Marmot review and a national focus on health disparities, as well as a period that saw austerity and increasingly stretched NHS funding and hospital budgets, which made it possible to track rises in disparity. In addition to a decade of data, the analysis covered a national period focusing on health inequalities.  

One of the study’s limitations was that it could only analyze disparities in terms of age, gender, level of area deprivation at the LSOA level, and location at the CCG level. This was due to the researchers’ limited ability to evaluate population data based on age, gender, year, and location. As a result, they were unable to draw any conclusions. As a result, they could not explain discrepancies at the patient level based on other significant characteristics like ethnicity, BMI, social position, income, or education.

This study looked at inequalities in access to joint replacement surgery and variations in clinical necessity. Because the study focused on the most prevalent reason for joint replacement (approximately 90% of major surgeries in the UK are for osteoarthritis), the provided findings do not apply to patients under 50 or who had surgery for a different reason. Finally, the presented results do not apply to patients under 50 or who had surgery for a different reason.  

Previous research has discovered that the incidence of joint replacements increases with age until it reaches the oldest age groups, after which it begins to decline; that women are more likely than men to undergo operations; and that higher-income groups are more likely to receive provision than lower-income groups. These trends support the concept that elderly adults are more likely to have joint replacement surgery.


According to the findings of this research effort, those with the lowest socioeconomic status had the lowest possibility of receiving government-funded hip replacement surgery. The study proposes that long-term underprovision of hip replacement could explain these discrepancies. Clinical demand is known to be highest in the poorest groups, who are also the least able to afford these operations privately.

On the other hand, this could provide proof of the Inverse Treatment Law, which claims that the availability of medical treatment correlates inversely with the requirement of the population being serviced. 

Leave a Reply


Free CME credits

Both our subscription plans include Free CME/CPD AMA PRA Category 1 credits.

Digital Certificate PDF

On course completion, you will receive a full-sized presentation quality digital certificate.

medtigo Simulation

A dynamic medical simulation platform designed to train healthcare professionals and students to effectively run code situations through an immersive hands-on experience in a live, interactive 3D environment.

medtigo Points

medtigo points is our unique point redemption system created to award users for interacting on our site. These points can be redeemed for special discounts on the medtigo marketplace as well as towards the membership cost itself.
  • Registration with medtigo = 10 points
  • 1 visit to medtigo’s website = 1 point
  • Interacting with medtigo posts (through comments/clinical cases etc.) = 5 points
  • Attempting a game = 1 point
  • Community Forum post/reply = 5 points

    *Redemption of points can occur only through the medtigo marketplace, courses, or simulation system. Money will not be credited to your bank account. 10 points = $1.

All Your Certificates in One Place

When you have your licenses, certificates and CMEs in one place, it's easier to track your career growth. You can easily share these with hospitals as well, using your medtigo app.

Our Certificate Courses