Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 5/2013

01-05-2013 | Symposium: Special Considerations for TKA in Asian Patients

Trends in Use of Total Knee Arthroplasty in Korea From 2001 to 2010

Authors: In Jun Koh, MD, Tae Kyun Kim, MD, Chong Bum Chang, MD, Hyung Joon Cho, MD, Yong In, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 5/2013

Login to get access

Abstract

Background

The use of total knee arthroplasty (TKA) has increased substantially in most Western countries. However, the trends in TKA use and changes in demographic characteristics of patients having TKA in Korea remain unclear.

Questions/purposes

We documented the trends in TKA use and in the demographics of patients undergoing TKA in Korea over the past decade and determined whether current TKA use in Korea corresponds to worldwide trends.

Methods

Using the Health Insurance Review and Assessment Service of Korea database, we analyzed TKA records (n = 398,218) from 2001 to 2010 in Korea. Trends in TKA use and demographics, including numbers and rates of primary and revision TKA, growth rate and the revision burden, and age- and sex-specific rates, were estimated. They were compared with nationwide TKA registry reports from other countries, and a systematic review was performed.

Results

Over the past decade, the primary and revision TKA rates increased by 407% and 267%, respectively. However, the revision burden remained 2%. The highest proportion was observed in 65 to 74 years old and the greatest increase in 75 to 84 years old, but a decrease was observed in those 55 to 64 years old. Women consistently had a ninefold higher TKA rate. The primary TKA rate was comparable with that of other countries, but the revision burden remained lower. In addition, old and female patients comprised considerably higher proportions in Korea.

Conclusions

During the past decade, TKA use in Korea has markedly increased and caught up with the use levels of most developed Western countries. Trends toward consistent growth in elderly patients and higher rates in females were observed. Appropriate healthcare strategies reflecting these trends in demographics are urgently needed in Korea.
Literature
2.
go back to reference Bini SA, Sidney S, Sorel M. Slowing demand for total joint arthroplasty in a population of 3.2 million. J Arthroplasty. 2011;26(Suppl):124–128.PubMedCrossRef Bini SA, Sidney S, Sorel M. Slowing demand for total joint arthroplasty in a population of 3.2 million. J Arthroplasty. 2011;26(Suppl):124–128.PubMedCrossRef
3.
go back to reference Bozic KJ, Kurtz SM, Lau E, Ong K, Chiu V, Vail TP, Rubash HE, Berry DJ. The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop Relat Res. 2010;468:45–51.PubMedCrossRef Bozic KJ, Kurtz SM, Lau E, Ong K, Chiu V, Vail TP, Rubash HE, Berry DJ. The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop Relat Res. 2010;468:45–51.PubMedCrossRef
4.
go back to reference Callahan CM, Drake BG, Heck DA, Dittus RS. Patient outcomes following tricompartmental total knee replacement. A meta-analysis. JAMA. 1994;271:1349–1357.CrossRef Callahan CM, Drake BG, Heck DA, Dittus RS. Patient outcomes following tricompartmental total knee replacement. A meta-analysis. JAMA. 1994;271:1349–1357.CrossRef
6.
go back to reference Chang RW, Pellisier JM, Hazen GB. A cost-effectiveness analysis of total hip arthroplasty for osteoarthritis of the hip. JAMA. 1996;275:858–865.PubMedCrossRef Chang RW, Pellisier JM, Hazen GB. A cost-effectiveness analysis of total hip arthroplasty for osteoarthritis of the hip. JAMA. 1996;275:858–865.PubMedCrossRef
7.
go back to reference Cho HJ, Chang CB, Kim KW, Park JH, Yoo JH, Koh IJ, Kim TK. Gender and prevalence of knee osteoarthritis types in elderly Koreans. J Arthroplasty. 2011;26:994–999.PubMedCrossRef Cho HJ, Chang CB, Kim KW, Park JH, Yoo JH, Koh IJ, Kim TK. Gender and prevalence of knee osteoarthritis types in elderly Koreans. J Arthroplasty. 2011;26:994–999.PubMedCrossRef
8.
go back to reference Cho HJ, Chang CB, Yoo JH, Kim SJ, Kim TK. Gender differences in the correlation between symptom and radiographic severity in patients with knee osteoarthritis. Clin Orthop Relat Res. 2010;468:1749–1758.PubMedCrossRef Cho HJ, Chang CB, Yoo JH, Kim SJ, Kim TK. Gender differences in the correlation between symptom and radiographic severity in patients with knee osteoarthritis. Clin Orthop Relat Res. 2010;468:1749–1758.PubMedCrossRef
9.
go back to reference Crowninshield RD, Rosenberg AG, Sporer SM. Changing demographics of patients with total joint replacement. Clin Orthop Relat Res. 2006;443:266–272.PubMedCrossRef Crowninshield RD, Rosenberg AG, Sporer SM. Changing demographics of patients with total joint replacement. Clin Orthop Relat Res. 2006;443:266–272.PubMedCrossRef
10.
go back to reference Culliford DJ, Maskell J, Beard DJ, Murray DW, Price AJ, Arden NK. Temporal trends in hip and knee replacement in the United Kingdom: 1991 to 2006. J Bone Joint Surg Br. 2010;92:130–135.PubMedCrossRef Culliford DJ, Maskell J, Beard DJ, Murray DW, Price AJ, Arden NK. Temporal trends in hip and knee replacement in the United Kingdom: 1991 to 2006. J Bone Joint Surg Br. 2010;92:130–135.PubMedCrossRef
11.
go back to reference Fehring TK, Odum SM, Troyer JL, Iorio R, Kurtz SM, Lau EC. Joint replacement access in 2016: a supply side crisis. J Arthroplasty. 2010;25:1175–1181.PubMedCrossRef Fehring TK, Odum SM, Troyer JL, Iorio R, Kurtz SM, Lau EC. Joint replacement access in 2016: a supply side crisis. J Arthroplasty. 2010;25:1175–1181.PubMedCrossRef
12.
go back to reference Fortin PR, Clarke AE, Joseph L, Liang MH, Tanzer M, Ferland D, Phillips C, Partridge AJ, Belisle P, Fossel AH, Mahomed N, Sledge CB, Katz JN. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42:1722–1728.PubMedCrossRef Fortin PR, Clarke AE, Joseph L, Liang MH, Tanzer M, Ferland D, Phillips C, Partridge AJ, Belisle P, Fossel AH, Mahomed N, Sledge CB, Katz JN. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42:1722–1728.PubMedCrossRef
13.
go back to reference Ibrahim T, Bloch B, Esler CN, Abrams KR, Harper WM. Temporal trends in primary total hip and knee arthroplasty surgery: results from a UK regional joint register, 1991-2004. Ann R Coll Surg Engl. 2010;92:231–235.PubMedCrossRef Ibrahim T, Bloch B, Esler CN, Abrams KR, Harper WM. Temporal trends in primary total hip and knee arthroplasty surgery: results from a UK regional joint register, 1991-2004. Ann R Coll Surg Engl. 2010;92:231–235.PubMedCrossRef
14.
go back to reference Iorio R, Robb WJ, Healy WL, Berry DJ, Hozack WJ, Kyle RF, Lewallen DG, Trousdale RT, Jiranek WA, Stamos VP, Parsley BS. Orthopaedic surgeon workforce and volume assessment for total hip and knee replacement in the United States: preparing for an epidemic. J Bone Joint Surg Am. 2008;90:1598–1605.PubMedCrossRef Iorio R, Robb WJ, Healy WL, Berry DJ, Hozack WJ, Kyle RF, Lewallen DG, Trousdale RT, Jiranek WA, Stamos VP, Parsley BS. Orthopaedic surgeon workforce and volume assessment for total hip and knee replacement in the United States: preparing for an epidemic. J Bone Joint Surg Am. 2008;90:1598–1605.PubMedCrossRef
15.
go back to reference Jain NB, Higgins LD, Ozumba D, Guller U, Cronin M, Pietrobon R, Katz JN. Trends in epidemiology of knee arthroplasty in the United States, 1990-2000. Arthritis Rheum. 2005;52:3928–3933.PubMedCrossRef Jain NB, Higgins LD, Ozumba D, Guller U, Cronin M, Pietrobon R, Katz JN. Trends in epidemiology of knee arthroplasty in the United States, 1990-2000. Arthritis Rheum. 2005;52:3928–3933.PubMedCrossRef
16.
go back to reference Khatod M, Inacio M, Paxton EW, Bini SA, Namba RS, Burchette RJ, Fithian DC. Knee replacement: epidemiology, outcomes, and trends in Southern California: 17,080 replacements from 1995 through 2004. Acta Orthop. 2008;79:812–819.PubMedCrossRef Khatod M, Inacio M, Paxton EW, Bini SA, Namba RS, Burchette RJ, Fithian DC. Knee replacement: epidemiology, outcomes, and trends in Southern California: 17,080 replacements from 1995 through 2004. Acta Orthop. 2008;79:812–819.PubMedCrossRef
17.
go back to reference Kim HA, Kim S, Seo YI, Choi HJ, Seong SC, Song YW, Hunter D, Zhang Y. The epidemiology of total knee replacement in South Korea: national registry data. Rheumatology (Oxford). 2008;47:88–91.CrossRef Kim HA, Kim S, Seo YI, Choi HJ, Seong SC, Song YW, Hunter D, Zhang Y. The epidemiology of total knee replacement in South Korea: national registry data. Rheumatology (Oxford). 2008;47:88–91.CrossRef
18.
go back to reference Kim S. Changes in surgical loads and economic burden of hip and knee replacements in the US: 1997-2004. Arthritis Rheum. 2008;59:481–488.PubMedCrossRef Kim S. Changes in surgical loads and economic burden of hip and knee replacements in the US: 1997-2004. Arthritis Rheum. 2008;59:481–488.PubMedCrossRef
19.
go back to reference Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am. 2005;87:1487–1497.PubMedCrossRef Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am. 2005;87:1487–1497.PubMedCrossRef
20.
go back to reference Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–785.PubMedCrossRef Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–785.PubMedCrossRef
21.
go back to reference Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467:2606–2612.PubMedCrossRef Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467:2606–2612.PubMedCrossRef
22.
go back to reference Kurtz SM, Ong KL, Schmier J, Mowat F, Saleh K, Dybvik E, Karrholm J, Garellick G, Havelin LI, Furnes O, Malchau H, Lau E. Future clinical and economic impact of revision total hip and knee arthroplasty. J Bone Joint Surg Am. 2007;89(Suppl 3):144–151.PubMedCrossRef Kurtz SM, Ong KL, Schmier J, Mowat F, Saleh K, Dybvik E, Karrholm J, Garellick G, Havelin LI, Furnes O, Malchau H, Lau E. Future clinical and economic impact of revision total hip and knee arthroplasty. J Bone Joint Surg Am. 2007;89(Suppl 3):144–151.PubMedCrossRef
23.
go back to reference Kurtz SM, Ong KL, Schmier J, Zhao K, Mowat F, Lau E. Primary and revision arthroplasty surgery caseloads in the United States from 1990 to 2004. J Arthroplasty. 2009;24:195–203.PubMedCrossRef Kurtz SM, Ong KL, Schmier J, Zhao K, Mowat F, Lau E. Primary and revision arthroplasty surgery caseloads in the United States from 1990 to 2004. J Arthroplasty. 2009;24:195–203.PubMedCrossRef
24.
go back to reference Lavernia CJ, Guzman JF, Gachupin-Garcia A. Cost effectiveness and quality of life in knee arthroplasty. Clin Orthop Relat Res. 1997;345:134–139.PubMedCrossRef Lavernia CJ, Guzman JF, Gachupin-Garcia A. Cost effectiveness and quality of life in knee arthroplasty. Clin Orthop Relat Res. 1997;345:134–139.PubMedCrossRef
25.
go back to reference Losina E, Thornhill TS, Rome BN, Wright J, Katz JN. The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic. J Bone Joint Surg Am. 2012;94:201–207.PubMedCrossRef Losina E, Thornhill TS, Rome BN, Wright J, Katz JN. The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic. J Bone Joint Surg Am. 2012;94:201–207.PubMedCrossRef
26.
go back to reference Losina E, Walensky RP, Kessler CL, Emrani PS, Reichmann WM, Wright EA, Holt HL, Solomon DH, Yelin E, Paltiel AD, Katz JN. Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med. 2009;169:1113–1121.PubMedCrossRef Losina E, Walensky RP, Kessler CL, Emrani PS, Reichmann WM, Wright EA, Holt HL, Solomon DH, Yelin E, Paltiel AD, Katz JN. Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med. 2009;169:1113–1121.PubMedCrossRef
27.
go back to reference Malchau H, Herberts P, Eisler T, Garellick G, Soderman P. The Swedish Total Hip Replacement Register. J Bone Joint Surg Am. 2002;84(Suppl 2):2–20.PubMed Malchau H, Herberts P, Eisler T, Garellick G, Soderman P. The Swedish Total Hip Replacement Register. J Bone Joint Surg Am. 2002;84(Suppl 2):2–20.PubMed
28.
go back to reference Mehrotra C, Remington PL, Naimi TS, Washington W, Miller R. Trends in total knee replacement surgeries and implications for public health, 1990-2000. Public Health Rep. 2005;120:278–282.PubMed Mehrotra C, Remington PL, Naimi TS, Washington W, Miller R. Trends in total knee replacement surgeries and implications for public health, 1990-2000. Public Health Rep. 2005;120:278–282.PubMed
29.
go back to reference Memtsoudis SG, Della Valle AG, Besculides MC, Gaber L, Laskin R. Trends in demographics, comorbidity profiles, in-hospital complications and mortality associated with primary knee arthroplasty. J Arthroplasty. 2009;24:518–527.PubMedCrossRef Memtsoudis SG, Della Valle AG, Besculides MC, Gaber L, Laskin R. Trends in demographics, comorbidity profiles, in-hospital complications and mortality associated with primary knee arthroplasty. J Arthroplasty. 2009;24:518–527.PubMedCrossRef
30.
go back to reference Mitsuyasu S, Hagihara A, Horiguchi H, Nobutomo K. Relationship between total arthroplasty case volume and patient outcome in an acute care payment system in Japan. J Arthroplasty. 2006;21:656–663.PubMedCrossRef Mitsuyasu S, Hagihara A, Horiguchi H, Nobutomo K. Relationship between total arthroplasty case volume and patient outcome in an acute care payment system in Japan. J Arthroplasty. 2006;21:656–663.PubMedCrossRef
35.
go back to reference Robertsson O, Bizjajeva S, Fenstad AM, Furnes O, Lidgren L, Mehnert F, Odgaard A, Pedersen AB, Havelin LI. Knee arthroplasty in Denmark, Norway and Sweden. Acta Orthop. 2010;81:82–89.CrossRef Robertsson O, Bizjajeva S, Fenstad AM, Furnes O, Lidgren L, Mehnert F, Odgaard A, Pedersen AB, Havelin LI. Knee arthroplasty in Denmark, Norway and Sweden. Acta Orthop. 2010;81:82–89.CrossRef
36.
go back to reference Robertsson O, Dunbar MJ, Knutson K, Lidgren L. Past incidence and future demand for knee arthroplasty in Sweden: a report from the Swedish Knee Arthroplasty Register regarding the effect of past and future population changes on the number of arthroplasties performed. Acta Orthop Scand. 2000;71:376–380.PubMedCrossRef Robertsson O, Dunbar MJ, Knutson K, Lidgren L. Past incidence and future demand for knee arthroplasty in Sweden: a report from the Swedish Knee Arthroplasty Register regarding the effect of past and future population changes on the number of arthroplasties performed. Acta Orthop Scand. 2000;71:376–380.PubMedCrossRef
37.
go back to reference Robertsson O, Knutson K, Lewold S, Lidgren L. The Swedish Knee Arthroplasty Register 1975-1997: an update with special emphasis on 41,223 knees operated on in 1988-1997. Acta Orthop Scand. 2001;72:503–513.PubMedCrossRef Robertsson O, Knutson K, Lewold S, Lidgren L. The Swedish Knee Arthroplasty Register 1975-1997: an update with special emphasis on 41,223 knees operated on in 1988-1997. Acta Orthop Scand. 2001;72:503–513.PubMedCrossRef
38.
go back to reference Serra-Sutton V, Allepuz A, Espallargues M, Labek G, Pons JM. Arthroplasty registers: a review of international experiences. Int J Technol Assess Health Care. 2009;25:63–72.PubMedCrossRef Serra-Sutton V, Allepuz A, Espallargues M, Labek G, Pons JM. Arthroplasty registers: a review of international experiences. Int J Technol Assess Health Care. 2009;25:63–72.PubMedCrossRef
39.
go back to reference Singh JA, Vessely MB, Harmsen WS, Schleck CD, Melton LJ 3rd, Kurland RL, Berry DJ. A population-based study of trends in the use of total hip and total knee arthroplasty, 1969-2008. Mayo Clin Proc. 2010;85:898–904.PubMedCrossRef Singh JA, Vessely MB, Harmsen WS, Schleck CD, Melton LJ 3rd, Kurland RL, Berry DJ. A population-based study of trends in the use of total hip and total knee arthroplasty, 1969-2008. Mayo Clin Proc. 2010;85:898–904.PubMedCrossRef
41.
go back to reference Steel N, Melzer D, Gardener E, McWilliams B. Need for and receipt of hip and knee replacement—a national population survey. Rheumatology (Oxford). 2006;45:1437–1441.CrossRef Steel N, Melzer D, Gardener E, McWilliams B. Need for and receipt of hip and knee replacement—a national population survey. Rheumatology (Oxford). 2006;45:1437–1441.CrossRef
44.
go back to reference Wells VM, Hearn TC, McCaul KA, Anderton SM, Wigg AE, Graves SE. Changing incidence of primary total hip arthroplasty and total knee arthroplasty for primary osteoarthritis. J Arthroplasty. 2002;17:267–273.PubMedCrossRef Wells VM, Hearn TC, McCaul KA, Anderton SM, Wigg AE, Graves SE. Changing incidence of primary total hip arthroplasty and total knee arthroplasty for primary osteoarthritis. J Arthroplasty. 2002;17:267–273.PubMedCrossRef
45.
go back to reference Yan CH, Chiu KY, Ng FY. Total knee arthroplasty for primary knee osteoarthritis: changing pattern over the past 10 years. Hong Kong Med J. 2011;17:20–25.PubMed Yan CH, Chiu KY, Ng FY. Total knee arthroplasty for primary knee osteoarthritis: changing pattern over the past 10 years. Hong Kong Med J. 2011;17:20–25.PubMed
Metadata
Title
Trends in Use of Total Knee Arthroplasty in Korea From 2001 to 2010
Authors
In Jun Koh, MD
Tae Kyun Kim, MD
Chong Bum Chang, MD
Hyung Joon Cho, MD
Yong In, MD
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 5/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2622-y

Other articles of this Issue 5/2013

Clinical Orthopaedics and Related Research® 5/2013 Go to the issue