A retrospective analysis of trends in primary knee arthroplasty in Germany from 2008 to 2018

Michael Worlicek,Maximilian Kerschbaum,Popp Daniel,Viola Freigang,Volker Alt,Matthias Koch,Peter Angele,Markus Rupp

doi:10.1038/s41598-021-84710-y

Michael Worlicek, Maximilian Kerschbaum + Show 6 more

Open Access

https://doi.org/10.1038/s41598-021-84710-y

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Abstract

Unicompartimental and total knee arthroplasty is one of the most successful and most performed operations worldwide. In the last years the number of primary knee arthroplasty increased constantly. The aim of this study is to analyze the rising numbers of primary knee arthroplasty and to see how it is used in Germany. In this retrospective study data, provided by the Federal Statistical Office of Germany from 2008 to 2018 was analyzed, using operation codes from the German procedure classification system and characteristics like age, sex and type of the prosthesis. We found a slight increase of unicompartimental and total knee arthroplasty over the investigated 10 years from 150.504 in 2008 up to 168.479 procedures in 2018, with a maximum of 169.334 in 2017. Most patients were female and over 65 years old. Interestingly, there was an obvious decrease of regular TKA in the year 2013, with a relevant impact on the total number of procedures. In the following years the number rised again reaching the former level in 2015 and is still increasing. The highest increase was found in partial knee arthroplasty, with a constant rise every year, starting with 7988 in 2008 up to 21.072 in 2018. In contrast, we found a relevant reduction of constrained prosthesis in primary TKA, whereas the number of semi-constrained prosthesis in primary TKA is again rising after a decrease in 2015. We found that the number of bicondylar TKA and especially UKA increased from 2008 to 2018. Regarding an aging population, we can expect a rising number for Primary knee arthroplasty and in consequence a rising number of revision arthroplasty in the future. This will be a challenging cost factor for the healthcare system in Germany.

Highlights

Unicompartimental and total knee arthroplasty is one of the most successful and most performed operations worldwide
There was an obvious decrease of bicondylar total knee arthroplasty (TKA) in the years 2012 (− 4.5%) and 2013 (− 13.3%) compared to 2011, with a relevant impact on the total number of procedures (Figs. 1a, 2a)
We found the highest increase in unicompartimental knee arthroplasty (UKA), with a constant rise every year, starting with 7.988 in 2008 up to 21.072 in 2018 (Fig. 2b), which represents a total increase of about 164% in one decade

Summary

Introduction

Unicompartimental and total knee arthroplasty is one of the most successful and most performed operations worldwide. We found a slight increase of unicompartimental and total knee arthroplasty over the investigated 10 years from 150.504 in 2008 up to 168.479 procedures in 2018, with a maximum of 169.334 in 2017. We can expect a rising number for Primary knee arthroplasty and in consequence a rising number of revision arthroplasty in the future This will be a challenging cost factor for the healthcare system in Germany. In Germany, primary total knee arthroplasty (TKA) is one of the most performed surgical procedures. Due to an increased life expectancy and demographic changes with an increasing number of older patients having a high demand on performance, the number primary knee arthroplasty is rising c onstantly[1,2]. Not all hospitals and surgeons send their data to the EPRD, so there might be a lack of numbers

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