"Identifying Information: Name","Knee Replacement Rate"
"Identifying Information: Short/Other Names","Age-Standardized Rate for Knee Replacements"
"Identifying Information: Description","This indicator measures the age-standardized hospitalization rate for all knee replacement procedures performed in acute care hospitals or same-day surgery facilities per 100,000 population age 18 and older.

The indicator includes all knee replacement types: total knee replacement, unicompartmental knee replacement (medial, lateral or patellofemoral) and patella-only procedures.

For further details, please see the General Methodology Notes (PDF)."
"Background, Interpretation and Benchmarks: Rationale","Knee replacement surgery has the potential to improve functional status, reduce pain and contribute to other gains in health-related quality of life. Over the past two decades, rates of knee replacement procedures have increased substantially. Wide inter-regional variation in joint replacement rates may be attributable to numerous factors, including the availability of services, provider practice patterns and patient preferences."
"Background, Interpretation and Benchmarks: HSP Framework Dimension","Health system resources"
"Background, Interpretation and Benchmarks: Areas of Need","Not applicable"
"Background, Interpretation and Benchmarks: Targets/Benchmarks","Not applicable"
"Available Data Years","2010
 to 2022"
"Available Data Years: Type of Year",Fiscal
"Availability of Results: Geographic Coverage","All provinces/territories"
"Reporting Level/Disaggregation",National
"Result Updates: Indicator Results","Web Tool:
Health Indicators e-Publication"
"Update Frequency","Every year"
"Result Updates: Latest Results Update Date","November 2023"
"Result Updates: Updates","Not applicable"
"Indicator Calculation: Description","(Total number of discharges for all knee replacements for patients age 18 and older ÷ Total mid-year population age 18 and older) × 100,000 (age-adjusted)"
"Indicator Calculation: Type of Measurement",Rate
"Indicator Calculation: Number or Rate","Per 100,000"
"Denominator: Description:","Total mid-year population age 18 and older"
"Numerator: Description:","Total number of discharges or same-day visits for all knee replacement procedures for patients age 18 and older

Unit of analysis: Single admission or same-day visit"
"Numerator: Inclusions:","Knee replacement procedures occurring during inpatient stay or same-day visit CCI: 1.VG.53^^ and 1.VP.53^^
	
	Note: Rates are based on the total number of discharges or same-day visits for knee replacement procedures in a given year. Therefore, a patient who received a simultaneous bilateral knee replacement or underwent multiple knee replacement procedures within a single hospital admission or same-day visit would be counted only once.
	Age at admission: 18 and older
	Sex recorded as male or female
	Admission to an acute care institution or day surgery facility (Facility Type Code = 1 or A)"
"Numerator: Exclusions:","Records with cement spacers not coded as revision (intervention code 1VG53LASLN and Intervention Status Attribute does not equal R)
	Knee replacement procedures that were abandoned after onset or performed out of hospital (Intervention Status Attribute = A or OOH Indicator Flag = Y)
	Newborn, stillbirth or cadaveric donor records (Admission Category Code = N, R or S)"
"Method of Adjustment","Direct standardization"
"Method of Adjustment: Direct Standardization - Standard Population","Standard Population
Canada 2011"
"Adjustment Applied",Age-adjusted
"Indicator Calculation: Geographic Assignment","Place of residence"
"Data Sources",DAD
"Quality Statement: Caveats and Limitations","Rates are based on the total number of discharges or same-day visits for knee replacement procedures in a given year. However, it is possible for a patient to undergo more than one knee replacement procedure in a single hospitalization or day surgery visit."
"Quality Statement: Trending Issues","Prior to 2013–2014, the Canadian Joint Replacement Registry (CJRR) annual report included results for knee replacements performed in acute care hospitals only. Beginning in 2013-2014, the results for knee replacement include both acute and day surgery cases.

As of 2013–2014, the knee replacement rates published in the Health Indicators E-Publication include additional patella-only replacement procedures. Comparability with previous years might be affected."
"Quality Statement: Comments","Regional results are available in the Health Indicators e-Publication.
	Provincial results are also available in Quick Stats. Please note the following:



	Prior to 2013–2014, results for Yukon, the Northwest Territories and Nunavut were suppressed in the CJRR annual report. However, their numbers are included in Canadian calculations.
	As of 2013–2014, knee replacements from day surgery settings are included in the CJRR annual report.
	Calculation of a patient's geography in the Health Indicators e-Publication is based on the Postal Code Conversion File (PCCF).
	Beginning with 2015–2016 data, procedures involving implantation of a cement spacer are excluded from knee replacement cases when it is not part of a revision surgery; comparability with previous years should not be affected."
References,"Not applicable"