Epidemiology of hospitalization for hip replacement: Which implications for orthopaedics and rehabilitation? A 15-year longitudinal study

Purpose: The increasing incidence of hip replacement (HR) is related to the ageing of the population and the increasing longevity of new implants. The primary purpose of this study is to assess the number of HR hospitalizations in Italy, referring to official national hospitalization reports. The secondary aim is to evaluate the characteristics of patients who underwent HR, comparing the future predictions of the prevalence of HR between Italy and other countries. Methods: The present study considered adult patients (aged 20 years or older) who underwent HP. The data regarding hospitalizations for HR performed between 2001 and 2015 were collected by the National Hospital Discharge reports carried out by the Italian Ministry of Health. These reports provided data concerning all hospital admission occurring in Italy, both from public and private institutions. Results: Overall, 64.5% of HR were performed on female patients, whereas only 35.5% were male. The median length of hospital stay was 12.3 ± 8.1 days. During the 15-year study period, the main primary diagnoses were osteoarthrosis, localized, primary (46.1%). In 2001, 66,171 hospitalizations for HR were performed, equivalent to 5.4% of all those included in the National Hospital Discharge report (1,228,025); in 2015, this figure reached 95,200 units 7.8% of the total. There has been an annual increase of HR of 2.63%. From 2001 to 2015, the incidence of operations increased from 144.1 to 192.3 per 100,000 residents with at least 20 years of age. Conclusions: This longitudinal study confirms the progressive incidence in HR hospitalizations and the burden for the healthcare system in orthopaedics and rehabilitation fields. Level of Evidence: Level II.