Analysis of Total Knee Arthroplasty Volume in the Brazilian Unified Health System
J.L.R. De Faria, V.E.M. Paes, G.D.R. Motta Filho, N.T. Cavanellas, J.P.G. Aramburú Filho, P.A.V. MaiaObjective:
To analyze the epidemiological profile of TKAs performed within the SUS from 2008 to 2024, assessing regional distribution and mean length of hospitalization, and to compare these findings with data from a reference center in orthopedics.
Methods:
This retrospective, observational, and descriptive study utilized secondary data from DATASUS. Annual procedure numbers and mean hospitalization duration were analyzed by region. Comparisons with the reference center included additional analyses excluding hospitalizations lasting ≥30 and ≥10 days to minimize the influence of prolonged stays.
Results:
A total of 118,972 TKAs were performed. The Southeast region accounted for 57.3% of procedures, whereas the North represented only 1.8%, demonstrating marked regional disparity. Surgeries increased by over 300% between 2008 and 2024, with a progressive reduction in mean hospital stay from 5.4 to 3.0 days. The hospital that was compared to performed approximately 7.5% of all SUS TKAs and exhibited a longer mean stay than the national average, although a consistent downward trend was observed after adjustment for exclusions.
Conclusion:
Access to TKA within the SUS expanded substantially, alongside gains in hospital efficiency. Nevertheless, significant regional disparities persist, highlighting the need for policies to decentralize high-complexity orthopedic services.