Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
Sporthopaedicum Regensburg, Regensburg, Germany.
Sci Rep. 2021 Mar 4;11(1):5225. doi: 10.1038/s41598-021-84710-y.
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.
单髁和全膝关节置换术是全球最成功和最常进行的手术之一。近年来，初次膝关节置换术的数量不断增加。本研究旨在分析初次膝关节置换术数量的上升，并了解其在德国的应用情况。在这项回顾性研究中，我们分析了德国联邦统计局提供的 2008 年至 2018 年的数据，使用德国手术分类系统的手术代码以及年龄、性别和假体类型等特征。我们发现，在所研究的 10 年内，单髁和全膝关节置换术的数量略有增加，从 2008 年的 150504 例增加到 2018 年的 168479 例，2017 年达到最高的 169334 例。大多数患者为女性，年龄在 65 岁以上。有趣的是，2013 年常规 TKA 的数量明显下降，对总手术数量有重大影响。在随后的几年中，数量再次上升，到 2015 年达到了以前的水平，并仍在继续增加。增幅最大的是部分膝关节置换术，每年都在稳步上升，从 2008 年的 7988 例上升到 2018 年的 21072 例。相比之下，我们发现初次 TKA 中约束性假体的数量明显减少，而初次 TKA 中半约束性假体的数量在 2015 年下降后再次上升。我们发现，从 2008 年到 2018 年，双髁 TKA 和 UKA 的数量有所增加。鉴于人口老龄化，我们可以预期初次膝关节置换术的数量将会增加，因此未来翻修关节置换术的数量也将会增加。这将是德国医疗保健系统面临的一个具有挑战性的成本因素。
