Trends in mortality from orthopaedic prosthetic device complications among older US adults, 1999-2023

Background and Aim Complications from orthopedic prosthetic devices, including infections and mechanical failures, remain a major cause of morbidity and mortality despite advances in arthroplasty care. This study examined national trends, demographic and geographic disparities, and recent shifts in mortality related to these complications among older U.S. adults from 1999 to 2023 using CDC WONDER data. Methods Deaths attributed to prosthetic device complications (ICD-10: T84.0–T84.9) were identified from the CDC WONDER Multiple Cause of Death database. Age-adjusted mortality rates (AAMRs) were calculated, and temporal trends analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Results From 1999 to 2023, 10,939 deaths were linked to orthopedic prosthetic device complications. AAMR declined from 0.82 to 0.54 per 100,000 (AAPC = –1.65%, p = 0.026). Males showed greater reductions (AAPC = –3.13%, p < 0.001) than females. Mortality decreased in both age groups but rose recently among adults aged 55–74 years. Black adults showed steady declines, while White adults had a late nonsignificant rise. Regional disparities persisted, with recent upturns in the South and Midwest. Most deaths occurred in inpatient settings (61.2%). Conclusion Mortality from orthopedic prosthetic device complications has declined nationally, yet a nonsignificant post-2019 uptick in several subgroups, together with persistent sex and regional disparities, warrants continued monitoring and highlights the need for enhanced infection control, specialized revision care, and equitable healthcare access.