| Name | Knee Replacement Rate |
| Short/Other Names |
Age-Standardized Rate for Knee Replacements |
| Description | This indicator measures the age-standardized hospitalization rate for all knee replacement procedures performed in acute care hospitals or same-day surgery facilities per 100,000 population age 18 and older. The indicator includes all knee replacement types: total knee replacement, unicompartmental knee replacement (medial, lateral or patellofemoral) and patella-only procedures. For further details, please see the General Methodology Notes. |
| Interpretation | Does not apply to this measure (that is, there is no predefined preference for the measure score) |
| HSP Framework Dimension |
Health System Inputs and Characteristics: Health system resources |
| Areas of Need |
Not applicable |
| Geographic Coverage |
All provinces/territories |
| Reporting Level/Disaggregation |
National, Province/Territory, Region |
| Indicator Results |
| Name | Knee Replacement Rate |
| Short/Other Names |
Age-Standardized Rate for Knee Replacements |
| Description | This indicator measures the age-standardized hospitalization rate for all knee replacement procedures performed in acute care hospitals or same-day surgery facilities per 100,000 population age 18 and older. The indicator includes all knee replacement types: total knee replacement, unicompartmental knee replacement (medial, lateral or patellofemoral) and patella-only procedures. For further details, please see the General Methodology Notes. |
| Calculation: Description | (Total number of discharges for all knee replacements for patients age 18 and older ÷ Total mid-year population age 18 and older) × 100,000 (age-adjusted) |
| Calculation: Geographic Assignment |
Place of residence |
| Calculation: Type of Measurement |
Rate - Per 100,000 |
| Calculation: Adjustment Applied |
Age-adjusted |
| Calculation: Method of Adjustment |
Direct Standardization |
| Denominator |
Description: |
| Numerator |
Description: Unit of analysis: Single admission Inclusions: CCI: 1.VG.53^^ and 1.VP.53^^ Note: Rates are based on the total number of discharges for knee replacement procedures in a given year. Therefore, a patient who received a simultaneous bilateral knee replacement or underwent multiple knee replacement procedures within a single hospital admission would be counted only once. 2. Age at admission: 18 and older 3. Sex recorded as male or female 4. Admission to an acute care institution or day surgery facility (Facility Type Code = 1 or A) 2. Knee replacement procedures that were abandoned after onset or performed out of hospital (Intervention Status Attribute = A or OOH Indicator Flag = Y) 3. Newborn, stillbirth or cadaveric donor records (Admission Category Code = N, R or S) |
| Rationale |
Knee replacement surgery has the potential to improve functional status, reduce pain and contribute to other gains in health-related quality of life. Over the past two decades, rates of knee replacement procedures have increased substantially. Wide inter-regional variation in joint replacement rates may be attributable to numerous factors, including the availability of services, provider practice patterns and patient preferences. |
| Interpretation |
Does not apply to this measure (that is, there is no predefined preference for the measure score) |
| HSP Framework Dimension |
Health System Inputs and Characteristics: Health system resources |
| Areas of Need |
Not applicable |
| Targets/Benchmarks |
Not applicable |
| References |
Not applicable |
| Data Sources |
DAD, HMDB, NACRS |
| Available Data Years |
Type of Year: |
| Geographic Coverage |
All provinces/territories |
| Reporting Level/Disaggregation |
National, Province/Territory, Region |
| Update Frequency |
Every year |
| Indicator Results |
Web Tool: |
| Updates |
Not applicable |
| Caveats and Limitations |
Rates are based on the total number of discharges for knee replacement procedures in a given year. However, it is possible for a patient to undergo more than one knee replacement procedure in a single hospitalization or day surgery visit. |
| Trending Issues |
Prior to 2013–2014, the Canadian Joint Replacement Registry (CJRR) annual report (https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC2625&lang=en&media=0) included results for knee replacements performed in acute care hospitals only. Beginning in 2013-2014, the results for knee replacement include both acute and day surgery cases. As of 2013–2014, the knee replacement rates published in the Health Indicators E-Publication include additional patella-only replacement procedures. Comparability with previous years might be affected. |
| Comments |
1. Regional results are available in the Health Indicators e-Publication. 2. Provincial results are also available in Quick Stats. Please note the following: –Prior to 2013–2014, results for Yukon, the Northwest Territories and Nunavut were suppressed in the CJRR annual report (https://www.cihi.ca/sites/default/files/document/cjrr-annual-report-2018-en.pdf). However, their numbers are included in Canadian calculations. –As of 2013–2014, knee replacements from day surgery settings are included in the CJRR annual report (https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC2625&lang=en&media=0). –Calculation of a patient's geography in the Health Indicators e-Publication is based on the Postal Code Conversion File (PCCF), whereas in the CJRR annual report (https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC2625&lang=en&media=0) it is based on the forward sortation area (FSA). –Beginning with 2015–2016 data, procedures involving implantation of a cement spacer are excluded from knee replacement cases when it is not part of a revision surgery; comparability with previous years should not be affected. |
