The Workers’ Compensation Research Institute (WCRI) published a new study on Recent Trends in Joint Replacement Among Workers’ Compensation Claims, conducted to offer a consistent framework for tracking these surgeries and provide a better understanding of who receives them, where they occur, and how surgical decisions influence claim costs and outcomes.
The analysis was based on data from 2 million claims across 32 states. Claims analyzed had more than seven days of lost time, with injuries between 2015-2022, and with fixed 24-month post-injury experience. The report focused on shoulder, hip, and knee replacements, which represent the majority of joint replacement surgeries
The WCRI found that the prevalence of joint replacement surgeries increased over the study period, from seven out of 1,000 claims to 8.3 per 1,000 claims, primarily driven by an increase in shoulder joint replacements.
The number of claims with inpatient procedures fell from 5.3 to 1.9 per 1,000 claims, while claims with outpatient procedures increased from 1.6 to 6.4 per 1,000 claims.
In 2021, knee joint replacement surgeries accounted for 43% of joint replacement procedures, followed by shoulder joint replacement surgeries at 36%, and hip joint replacement surgeries at 21%.
The timing of joint replacement surgeries varied by body part, due to the nature of the underlying injuries and the care patterns prior to joint replacement surgeries. More than one-third of hip-replacements occurred within 30 days of injury, while most knee replacements occurred over one year after the injury date, and most shoulder replacements occurring within a year of injury.
Claims with a joint replacement had total costs ranging from $116,000 to $129,000, depending on body part, with temporary disability duration ranging 43-55 weeks. Joint replacement surgeries were primarily seen in male workers over the age of 55.
A wide variation in joint replacements was visible across the 32 study states, highlighting differences in worker characteristics, injury type, and state policies around the utilization of medical and surgical treatment.
