Time to Total Hip Arthroplasty Among Patients in the US Military Health System
Authors' conclusion
In this cohort study of TRICARE enrollees, variation in THA receipt was identified across multilevel factors.
Study context
- Population
- Adult TRICARE enrollees diagnosed with hip OA between March 1, 2018, and March 30, 2023, without diagnosis in the past 3 years, with at least 1 additional visit 1 week to 3 years after the index date; US military and civilian health care facilities
- Participants
- 37,239 enrollees
- Exposure
- Patient-, care- and structural-level factors and time to total hip arthroplasty (THA) after hip OA diagnosis
- Outcome
- Time to THA within 3 years of index diagnosis
- Follow-up
- 3 years
Methodological detailspiecewise exponential additive model
- Piecewise exponential additive model
Main finding
As reported in the abstract
Time to THA within 3 years of index diagnosis (piecewise exponential additive model)
Patients diagnosed with hip osteoarthritis
28%
10 502 events
Incidence rate ratio (95% CI)
Asian and Pacific Islandervs White
0.76(0.66–0.88)
Blackvs White
0.79(0.74–0.85)
Hispanicvs White
0.84(0.73–0.96)
Psychiatric diagnoses before the index diagnosis
0.79(0.76–0.83)
Pain-related diagnoses before the index diagnosis
0.69(0.66–0.72)
Obesity diagnoses before the index diagnosis
0.92(0.88–0.96)
Elevated comorbidity index scores
0.85(0.74–0.97)
Diagnosed in the purchased care system
0.38(0.36–0.40)
Diagnosed in later years
0.97(0.95–0.99)
1 injection before the index diagnosis
0.83(0.77–0.90)
More injections before the index diagnosis
0.75(0.70–0.81)
2 or more imaging visit days before the index diagnosis
0.77(0.69–0.86)
Retired service membersvs active-duty service members
1.39(1.24–1.56)
Family membersvs active-duty service members
1.48(1.30–1.69)
Malevs female
1.20(1.11–1.31)
Increasing orthopedic surgeon visit days after the index diagnosis
1.67(1.64–1.69)
Increasing opioid prescriptions after the index diagnosis
1.02(1.01–1.03)
Increasing imaging visit days after the index diagnosis
1.26(1.24–1.28)
Observational data: associations, not effects.
Original publication
Time to Total Hip Arthroplasty Among Patients in the US Military Health System. JAMA Netw Open. Published 1 October 2025. doi:10.
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