Epidemiological and Economic Impact of Primary Total Knee Arthroplasty in the Brazilian Unified Health System (SUS): National Analysis of 86,000 Procedures (2014–2024)
G.L. Silva, V.F. Carvalho, V.M. De Azevedo, C.S.P. Xavier, C.E.M. ZamunerObjectives:
To analyze the epidemiological profile and economic impact of primary total knee arthroplasty (TKA) performed within the Brazilian Unified Health System (SUS).
Methods:
This ecological, descriptive, and retrospective study used secondary data from the SUS Hospital Information System (SIH/SUS), corresponding to procedure 0408050063 (primary total knee arthroplasty), covering the period from 2014 to 2024. Data on hospitalizations, total approved costs, in-hospital deaths, and length of hospital stay were collected and stratified by year and geographic region. Descriptive statistics were applied to calculate totals, means, percentages, and lethality rates.
Results:
A total of 86,004 hospitalizations were recorded during the study period, with a cumulative cost of R$ 388,542,002.85 and 99 in-hospital deaths. The Southeast region accounted for the highest proportion of procedures (57.4%), followed by the South region. The overall mean cost per hospitalization was R$ 4,517.72, and the mean length of hospital stay was 3.69 days. The global in-hospital lethality rate was 0.12%. A marked reduction in hospitalizations was observed in 2020 and 2021, coinciding with the COVID-19 pandemic, followed by a substantial recovery from 2022 onwards.
Conclusion:
Primary total knee arthroplasty represents a significant epidemiological and economic burden within the SUS, with pronounced regional disparities in procedure distribution. The temporary decline in surgical volume during the COVID-19 pandemic highlights the vulnerability of elective orthopedic care within public health systems. These findings provide relevant evidence to support healthcare planning, resource allocation, and organization of orthopedic services.