Utilization of upper limb joint replacements during 1972–90: The mayo clinic experience

R. Madhok, D. G. Lewallen, S. L. Wallrichs, D. M. Ilstrup, L. J. Melton

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Increasing application of expensive medical technologies, including joint replacement, is of concern in the current economic climate. Successful upper limb joint replacements (ULJRs) are being performed, but few detailed data about their utilization are available. To explore the resource implications of such surgery, the utilization of total shoulder replacement (TSR), total elbow replacement (TER) and total wrist replacement (TWR) were examined from the time these procedures first became available at the Mayo Clinic up to 1990. The age- and sex-adjusted utilization rate for TSR among Olmsted County, Minnesota, residents was 1.8 per 100000 person-years (p-y), 0.8 per 100000 p-y for TER and 1.1 per 100000 p-y for TWR. Overall utilization of primary ULJR among Olmsted County residents during the 19-year study period was 3.8 per 100000 p-y. The commonest indication for TSR was osteoarthritis (46 per cent) and for TER and TWR was rheumatoid arthritis (50 and 81 per cent respectively). There was no consistent trend in the utilization of these procedures among Olmsted County residents, but the number of referral patients receiving a ULJR at the Mayo Clinic increased steadily during the study period. The Mayo Clinic experience suggests an increasing demand for ULJR, particularly TSR and TER. With continued advances in, and diffusion of, the technology this demand may increase further.

Original languageEnglish (US)
Pages (from-to)239-244
Number of pages6
JournalProceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Issue number4
StatePublished - Dec 1993

ASJC Scopus subject areas

  • Mechanical Engineering


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