Disease burden of knee osteoarthritis patients with a joint replacement compared to matched controls: a population-based analysis of a Dutch medical claims database

J. T. H. Nielen, A. Boonen, P. C. Dagnelie, B. J. F. van den Bemt, P. J. Emans, F. P. J. G. Lafeber, W. E. van Spil, F. de Vries*, P. M. J. Welsing

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

29 Downloads (Pure)


Objective: On a population level, the incidence of knee prostheses (KPs) has increased, but excess health care costs per patient, compared to matched controls without a KP, in the years surrounding these procedures and their determinants are largely unknown. We therefore aimed to provide estimates of age-and sex-specific incidence of KPs, revision KPs, and prosthesis complications in patients with knee osteoarthritis (OA) and to determine excess health care costs in the years surrounding surgery compared with matched controls. Methods: All KPs in OA patients in the Achmea Health Database were identified as well as up to four controls. Incidence rates of KPs, revisions, and complications from 2006 to 2013 were determined. Annual health care cost and excess costs (over matched controls) preceding, during, and after surgery were calculated and their determinants were evaluated. Results: The increased incidence of KPs, revisions, and complications was strongest in younger age categories and men. The average costs per patient were relatively stable between 2006 and 2012. KP patient's annual health care costs increased towards the year of surgery. After surgery, costs decreased, but remained higher as compared to costs prior to surgery. High post-surgery costs were mainly associated with subsequent revisions or additional KPs, but costs were also higher in females, lower age categories, and lower social economic status. Conclusion: These results underscore the increasing burden and medical need associated with end-stage OA, especially in younger age categories. Improvement of guidelines tailored to individual patient groups aimed at avoiding complications and revisions is required to counteract this increasing burden. (C) 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)202-210
Number of pages9
JournalOsteoarthritis and Cartilage
Issue number2
Publication statusPublished - 1 Feb 2018


  • Knee osteoarthritis
  • Knee arthroplasty
  • Knee replacement
  • Incidence rate
  • Health care costs

Cite this