Extreme variations in racial rates of total hip arthroplasty for primary coxarthrosis: a population-based study in San Francisco

Article Abstract:

The incidence and need for hip replacement surgery varies according to race. Records for all hip replacements performed in 17 San Francisco area hospitals over a five-year period were reviewed because San Francisco is a racially diverse community. The greatest annual rate of surgeries was found white women at 97 per 100,000. In decending order of incidence were followed by white men, black women, black men, Hispanic women, Hispanic men, and Asians. Asians had hip replacements at 10% of the rate for whites. Differences were due to fewer cases of severe arthritic disease. Sixty-six percent of whites had a hip replacement for this reason compared with 54% among blacks, 53% among Hispanics, and 28% among Asians. These magnitude of these differences suggests that a lower incidence of arthritic disease is a larger factor than differences in access to health care. These same differences in rates are also found when comparing international studies of more homogenous populations.

Health aspects, Minorities, Arthroplasty

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Human arthroplasty derived macrophages differentiate in to osteoclastic bone resorbing cells

Article Abstract:

Cells called macrophages present in the area surrounding a joint replacement appear to be capable of transforming into cells called osteoclasts that degrade bone. This process may be responsible for the loosening seen in some joint replacement failures. Macrophages taken from loosened hip replacements (study cells) and new hip replacements (control cells) were mixed with bone-producing rat cells after a 14-day growth period. There was evidence of osteoclast activity in the study cells after the rat cells were added but not before. There was no evidence of osteoclast activity in the control cells.

Physiological aspects, Macrophages, Bone resorption, Artificial joints, Joint prostheses

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Projecting the need for hip replacement over the next three decades: influence of chenging demography and threshold for surgery

Article Abstract:

The authors have estimated the increase in need for hip replacement surgery over the next 30 years based on demographic changes in the United Kingdom, with no change in the age and sex specifics currently in use. They predict an increase of 40% on that basis, and allowing that changes in the point at which a need for surgery is determined might increase it further, possibly up to double the current rate.

Statistical Data Included, Forecasts and trends, Surgery

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