The first national joint registry system in Asia was established in Taiwan this year, amid a growing demand for knee replacements, the National Health Insurance Administration (NHIA) said yesterday.
The most common reason for a knee joint replacement is degenerative joint disease, followed by rheumatoid arthritis, said orthopedist Ku Ming-chou (古鳴洲), vice president of Show Chwan Memorial Hospital.
About 48,000 joint replacement surgeries were reported nationwide last year, and over the next 20 years that number is expected to rise twofold or threefold, Ku said.
Records from medical centers between 2007 and 2014 show that the rate of a second surgery after a knee replacement is 0.6 percent after one year and 2.18 percent after five years, the NHIA said.
The need for a second knee replacement — or more — depends on several factors, including the material of the artificial joint, infection, wear and tear, or even the skill of the surgeons, Ku said.
However, if an artificial joint is repeatedly replaced, the loss of bone parts during surgery can increase the risk of infection, he said.
“Some parts of the bones must be cut off when replacing an artificial joint, so the result might not be as good as the first replacement surgery … and that is why we need more data to determine the reasons [for additional surgeries] and improve treatment,” he said.
The UK established its National Joint Registry in 2006, and through the data collected by the registry it was able to detect a serious problem with a poorly performing metal hip replacement device that had been implanted in many women, which triggered a worldwide recall of the product, Ku said.
A registry can help discover which facilities are performing repeated joint replacement surgeries and which devices are repeatedly being replaced, which can help improve the quality of treatment, save unnecessary medical expenses and reduce the risk to patients, he said.
NHIA Director-General Lee Po-chang (李伯璋) said Sweden, the UK, Australia, New Zealand and a few other countries have established joint registries, and Sweden saw a drop in the repeated joint replacement rate from 17 percent to 7 percent after its system was established.
Women are three times more likely to need joint replacement than men, Ku said.
Climbing stairs can cause excessive pressure to the knees — about two to three times the weight of a body — while using a squat toilet can increase the pressure on the knees by about seven times the body weight, so women older than 50 are advised to avoid using squat toilets, he said.
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