ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 180 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Assessment of Bone Displacement Under Loading Following Periprosthetic Fracture Repair With Weight-Bearing CT
Assessment of Bone Displacement Under Loading Following Distal Femur Periprosthetic Fracture Repair With Weight-Bearing CT and Conventional CT
Effects of Different Vibration Applications on Bone Turnover Markers and Functionality After Total Knee Arthroplasty in Women With Osteopenia: A Randomized Controlled Trial
Who cites it
180 citing papers in PubMed, 10 syntheses or guidelines pooled it, 302 citations in OpenAlex.
- A comparison on the clinical outcomes of using intraoperative load sensors versus manual balancing in total knee arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Blood Flow Restriction Training in Knee Arthroplasty: A Systematic Review of Current Evidence on Postoperative Muscle Strength and Function.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Continuous outcomes of robotic-assisted total knee arthroplasty trials are statistically fragile.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Association between malnutrition status and total joint arthroplasty periprosthetic joint infection and surgical site infection: a systematic review meta-analysis.Journal of orthopaedic surgery and research · 2024Pooled it
- The use of radiomic analysis of magnetic resonance imaging findings in predicting features of early osteoarthritis of the knee-a systematic review and meta-analysis.Irish journal of medical science · 2024Pooled it
- A systematic review and meta-analysis of hybrid vs. cemented stems - which method is more optimal for revision total knee arthroplasty?BMC musculoskeletal disorders · 2024Pooled it
- Indicators and medical tests to identify lower limb swelling causes after total knee arthroplasty: a Delphi study with multidisciplinary experts.Journal of orthopaedic surgery and research · 2023Pooled it
- Physical activity after revision knee arthroplasty including return to sport and work: a systematic review and meta-analysis including GRADE.BMC musculoskeletal disorders · 2023Pooled it
- Novel diagnostic markers for periprosthetic joint infection: a systematic review.Frontiers in cellular and infection microbiology · 2023Pooled it
- Role of D-dimer and Fibrinogen in the Diagnosis of Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis.Orthopaedic surgery · 2021Pooled it
- Six-degree-of-freedom knee motion during treadmill walking in mechanically and kinematically aligned TKA.Scientific reports · 2026Trial
- [SOG-Special Orthopedic Geriatrics : First interim results of a randomized controlled study on integrated orthogeriatric care in elective hip and knee arthroplasty].Orthopadie (Heidelberg, Germany) · 2024Trial
- Effect of Combined Kinematic Chain Exercise on Physical Function, Balance Ability, and Gait in Patients with Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial.International journal of environmental research and public health · 2023Trial
- Radiological and Clinical Evaluation of the Ipsilateral Ankle of Patients Who Underwent Total Knee Arthroplasty: A Prospective Study.Journal of clinical medicine · 2026Article
- Arthrofibrosis After Total Knee Arthroplasty: Biological Mechanisms, Diagnosis, and Treatment: An International Consensus Symposium.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2026Article
- When demography challenges policy: the rising burden of proximal femur fractures as a role model and driver for geriatric trauma care in Germany.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- High-Volume Hospitals Are Associated With Lower Rates of Mortality Following Revision Arthroplasty for Periprosthetic Joint Infection.Arthroplasty today · 2026Article
- Preoperative lower radiographic osteoarthritis severity in primary total knee arthroplasty increases revision risk by tenfold compared to severe osteoarthritis.Archives of orthopaedic and trauma surgery · 2026Article
- Does implant weight matter? The effect of total knee arthroplasty on thigh mass distribution and estimated hip loading.Journal of experimental orthopaedics · 2026Article
- Diverging trends in primary and revision arthroplasty in Germany: projections and implications for healthcare delivery for the next ten years.International orthopaedics · 2026Article
120 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTotal knee arthroplasty (TKA) rates have increased substantially in the recent decades worldwide, with Germany being one of the leading countries in the prevalence of TKA. The aim of this study was to provide an overview of treatment changes during the last decade and to project the expected burden of primary and revision TKA (rTKA) for the next 30 years.
methodsComprehensive nationwide data from Germany was used to quantify primary and revision TKA rates as a function of age and gender. Projections were performed with use of a Poisson regression models and a combination of exponential smoothing and autoregressive integrated moving average models on historical procedure rates in relation to official population projections from 2020 to 2050.
resultsThe incidence rate of primary TKAs is projected to increase by around 43% to 299 per 100,000 inhabitants [95% CI 231-368], leading to a projected total number of 225,957 primary TKAs in 2050 (95% CI 178,804-276,442). This increase has been related to a growing number of TKA performed in male patients, with the highest increase modelled in patients between 50 and 65 years of age. At the same time, the annual total number of revision procedures is forecast to increase even more rapidly by almost 90%, accounting for 47,313 (95% CI 15,741-78,885; IR = 62.7 per 100,000, 95% CI 20.8-104.5) procedures by 2050. Those numbers are primarily associated with a rising number of rTKAs secondary to periprosthetic joint infection (PJI).
conclusionsUsing this country- specific forecast approach, a rising number of primary TKA and an even more rapidly growing number of rTKA, especially for PJI, has been projected until 2050, which will inevitably provide a huge challenge for the future health care system. As many other industrialized nations will face similar demographic and procedure-specific developments, these forecasts should be alarming for many health care systems worldwide and emphasize the tremendous need for an appropriate financial and human resource management in the future. LEVEL OF EVIDENCE: Level III, prognostic study, economic and decision analysis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.