Top

Published in:

01-12-2011 | Original Paper

International survey of primary and revision total knee replacement

Authors: Steven M. Kurtz, Kevin L. Ong, Edmund Lau, Marcel Widmer, Milka Maravic, Enrique Gómez-Barrena, Maria de Fátima de Pina, Valerio Manno, Marina Torre, William L. Walter, Richard de Steiger, Rudolph G. T. Geesink, Mikko Peltola, Christoph Röder

Published in: International Orthopaedics | Issue 12/2011

Abstract

Purpose

Total knee arthroplasty (TKA) is currently the international standard of care for treating degenerative and rheumatologic knee joint disease, as well as certain knee joint fractures. We sought to answer the following three research questions: (1) What is the international variance in primary and revision TKA rates around the world? (2) How do patient demographics (e.g., age, gender) vary internationally? (3) How have the rates of TKA utilization changed over time?

Methods

The survey included 18 countries with a total population of 755 million, and an estimated 1,324,000 annual primary and revision total knee procedures. Ten national inpatient databases were queried for this study from Canada, the United States, Finland, France, Germany, Italy, the Netherlands, Portugal, Spain, and Switzerland. Inpatient data were also compared with published registry data for eight countries with operating arthroplasty registers (Denmark, England & Wales, Norway, Romania, Scotland, Sweden, Australia, and New Zealand).

Results

The average and median rate of primary and revision (combined) total knee replacement was 175 and 149 procedures/100,000 population, respectively, and ranged between 8.8 and 234 procedures/100,000 population. We observed that the procedure rate significantly increased over time for the countries in which historical data were available. The compound annual growth in the incidence of TKA ranged by country from 5.3% (France) to 17% (Portugal). We observed a nearly 27-fold range of TKA utilization rates between the 18 different countries included in the survey.

Conclusion

It is apparent from the results of this study that the demand for TKA has risen substantially over the past decade in countries around the world.

Serra-Sutton V, Allepuz A, Espallargues M, Labek G, Pons JM (2009) Arthroplasty registers: a review of international experiences. Int J Technol Assess Health Care 25(1):63–72. doi:10.1017/S0266462309090096 PubMedCrossRef

Losina E, Walensky RP, Kessler CL, Emrani PS, Reichmann WM, Wright EA, et al. (2009) Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med 169(12):1113–1121; discussion 1121–1112. doi:10.1001/archinternmed.2009.136.

Krummenauer F, Wolf C, Gunther KP, Kirschner S (2009) Clinical benefit and cost effectiveness of total knee arthroplasty in the older patient. Eur J Med Res 14(2):76–84PubMed

Rasanen P, Paavolainen P, Sintonen H, Koivisto AM, Blom M, Ryynanen OP et al (2007) Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs. Acta Orthop 78(1):108–115. doi:10.1080/17453670610013501 PubMedCrossRef

Burns AW, Bourne RB, Chesworth BM, MacDonald SJ, Rorabeck CH (2006) Cost effectiveness of revision total knee arthroplasty. Clin Orthop Relat Res 446:29–33. doi:10.1097/01.blo.0000214420.14088.76 PubMedCrossRef

Hirsch HS (1998) Total joint replacement: a cost-effective procedure for the 1990s. Med Health RI 81(5):162–164

Scheerlinck T, Druyts P, Casteleyn PP (2004) The use of primary total hip arthroplasty in university hospitals of the European Union. Acta Orthop Belg 70(3):231–239PubMed

Labek G, Stoica CI, Bohler N (2008) Comparison of the information in arthroplasty registers from different countries. J Bone Joint Surg Br 90(3):288–291. doi:10.1302/0301-620X.90B3.19556 PubMedCrossRef

Kurtz SM, Mowat F, Ong K, Chan N, Lau E, Halpern M (2005) Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am 87(7):1487–1497PubMedCrossRef

10.

Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89(4):780–785. doi:10.2106/JBJS.F.00222 PubMedCrossRef

11.

Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ (2009) Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res 467(10):2606–2612. doi:10.1007/s11999-009-0834-6 PubMedCrossRef

12.

de Bruin A, Kardaun J, Gast F, de Bruin E, van Sijl M, Verweij G (2004) Record linkage of hospital discharge register with population register: experiences at Statistics Netherlands. Statistical Journal of the UN Economic Commission for Europe, IOS Press, 21(1):23–32

13.

Australian Orthopaedic Association (2010) National Joint Replacement Registry. Annual report. Available from: http://www.dmac.adelaide.edu.au/aoanjrr/publications.jsp. Accessed 22 February 2011

14.

Willis-Owen CA, Brust K, Alsop H, Miraldo M, Cobb JP (2009) Unicondylar knee arthroplasty in the UK National Health Service: an analysis of candidacy, outcome and cost efficacy. Knee 16(6):473–478. doi:10.1016/j.knee.2009.04.006 PubMedCrossRef

15.

Robertsson O (2007) Knee arthroplasty registers. J Bone Joint Surg Br 89(1):1–4. doi:10.1302/0301-620X.89B1.18327 PubMed

16.

von Knoch F, Malchau H (2009) Why do we need a national joint replacement registry in the United States? Am J Orthop (Belle Mead NJ) 38(10):500–503

17.

Culliford DJ, Maskell J, Beard DJ, Murray DW, Price AJ, Arden NK (2010) Temporal trends in hip and knee replacement in the United Kingdom: 1991 to 2006. J Bone Joint Surg Br 92(1):130–135. doi:10.1302/0301-620X.92B1.22654 PubMedCrossRef

18.

Kim HA, Kim S, Seo YI, Choi HJ, Seong SC, Song YW et al (2008) The epidemiology of total knee replacement in South Korea: national registry data. Rheumatol Oxf 47(1):88–91. doi:10.1093/rheumatology/kem308 CrossRef

19.

Romanini E, Manno V, Conti S, Baglio G, Di Gennaro S, Masciocchi M et al (2009) Interregional mobility for total knee arthroplasty. Ann Ig 21(4):329–336PubMed

20.

Kadono Y, Yasunaga H, Horiguchi H, Hashimoto H, Matsuda S, Tanaka S et al (2010) Statistics for orthopedic surgery 2006–2007: data from the Japanese Diagnosis Procedure Combination database. J Orthop Sci 15(2):162–170. doi:10.1007/s00776-009-1448-2 PubMedCrossRef

Title: International survey of primary and revision total knee replacement
Authors: Steven M. Kurtz
Kevin L. Ong
Edmund Lau
Marcel Widmer
Milka Maravic
Enrique Gómez-Barrena
Maria de Fátima de Pina
Valerio Manno
Marina Torre
William L. Walter
Richard de Steiger
Rudolph G. T. Geesink
Mikko Peltola
Christoph Röder
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 12/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-011-1235-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

International survey of primary and revision total knee replacement

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2011

A systematic review of outcome and failure rate of uncemented Scandinavian total ankle replacement

Synergistic effect of recombinant human bone morphogenic protein-7 and osteogenic differentiation medium on human bone-marrow-derived mesenchymal stem cells in vitro

Outcome after pelvic sarcoma resection and reconstruction with a modular hemipelvic prostheses

Total hip replacement with an uncemented Wagner cone stem for patients with congenital hip dysplasia

Comment on Sen et al.: Posterior wall reconstruction using iliac crest strut graft in severely comminuted posterior acetabular wall fracture

Reply to the letter to the editor: Has the role of exchange nailing in femoral nonunion diminished?