Primary Total Knee Arthroplasties In The Brazilian Public Health System (2008–2024)
L.M. Azi, G.R. Azi, A. GuedesObjectives:
To describe the number and regional distribution of total knee arthroplasties (TKA) performed within the Brazilian Unified Health System (SUS) from 2008 to 2024.
Methods:
This retrospective, population-based study analyzed primary TKA procedures recorded in the Hospital Information System of the Brazilian Unified Health System (SIH/SUS). Data were obtained from the Department of Informatics of SUS (DATASUS), and population data were retrieved from the Brazilian Institute of Geography and Statistics (IBGE). Hospital admissions were included when the primary procedure code corresponded to primary total knee arthroplasty (04.08.05.006-3), according to the SUS Procedures Table (SIGTAP). The analyzed variables included region of hospitalization, primary diagnosis, and approved number of procedures.
Results:
Between 2008 and 2024, a total of 2,908,321 TKAs were performed in Brazil. The Southeast region accounted for 1,848,486 procedures, followed by the South (648,126), Northeast (226,633), Central-West (136,109), and North (48,967). Although the Southeast has approximately twice the population of the Northeast, the number of TKAs performed was seven times higher. Similarly, compared with the North and Central-West regions, the Southeast showed a disproportionately higher number of procedures relative to population size. In contrast, comparison between Southeast and South regions demonstrated proportional relationship between population size and number of TKAs.
Conclusion:
Total knee arthroplasties in Brazil are unevenly distributed, with a marked concentration in the Southeast and South regions. These disparities cannot be explained solely by population size, indicating inequalities in access to surgical care and emphasizing the need for public health policies promoting equitable availability of TKA nationwide.