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

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

doi:10.1038/s41598-021-84710-y

Cited by 14 publications

(7 citation statements)

References 33 publications

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“…Especially, unicompartimental knee arthroplasty (UKA) has become popular due to suggested benefits such as less tissue trauma, reduced blood loss during surgery, faster rehabilitation, and improved range of motion [ 3 ]. In Germany, UKA procedures nearly tripled over the last decade up to 21,072 performed procedures in 2018 [ 4 ]. However, despite good clinical outcomes implant survival is inferior to that of total knee arthroplasties with higher risk for aseptic loosening and periprosthetic fractures [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Revision arthroplasty after unicompartimental knee arthroplasty

et al. 2021

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Background Unicompartimental knee arthroplasty (UKA) is a promising and increasing application to treat unicompartimental knee osteoarthritis. However, revision arthroplasty numbers after UKA are unknown. Therefore, aim of this study was to determine the nationwide burden of revision after UKA by answering the following questions: (1) How did numbers of revision UKA procedures developed over the last decade as a function of age and gender? (2) How high is the percentage of revision UKA procedures due to infection? (3) Which therapy strategy was chosen for surgical treatment of aseptic revision UKA? Methods Revision arthroplasty rates as a function of age, gender, infection and type of prosthesis were quantified based on Operation and Procedure Classification System codes using revision knee arthroplasty data from 2008 to 2018, provided by the Federal Statistical Office of Germany (Destatis). Results Over the last decade, revision UKA increased by 46.3% up to 3105 procedures in 2018. A trend towards higher numbers in younger patients was observed. Septic interventions constituted 5.7% of all revisions, whereby total procedures increased by 67.1% from 2008 through 2018. The main treatment strategy was an exchange to a bicondylar surface replacement prosthesis, which was done in 63.70% of all cases, followed by exchange to a femoral and tibial shaft-anchored (16.2% of all revisions). Conclusion The increasing number of revision arthroplasty after UKA in Germany, especially in younger patients and due to infection, underlines the need for future efforts to improve treatment strategies beyond UKA to delay primary arthroplasty and avoid periprosthetic joint infection.

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Section: Introductionmentioning

confidence: 99%

Revision arthroplasty after unicompartimental knee arthroplasty

et al. 2021

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“…In the presence of a defect in one of the tibial condyles greater than 5 mm, the use of appropriate sized augments and the use of an endoprosthesis with a tibial extension. 6. In patients with gonarthrosis, with significant damage to the ligamentous apparatus of the knee joint, namely the presence of a complete failure of the lateral stabilisers, it is advisable to perform total arthroplasty with an all-articular joint replacement.…”

Section: Discussionmentioning

confidence: 99%

“…From 150,504 in 2008 to 169,334 in 2017. Along with total knee arthroplasty, unicomponent (unicondylar) arthroplasty is also used [6]. Out of 1053 total knee arthroplasty operations (mean age 66,9 years (SD 8.8); 58,6 % women), 78.1 % had good treatment results [7].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Patients With Osteoarthritis of the Knee Joints

Osadchuk,

Kalashnikov,

Kostohryz

et al. 2023

Clin. and prev. med.

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Introduction. Osteoarthritis affects 7 % of the world’s population. The number of affected people worldwide increased by 48 % from 1990 to 2019. At the initial stages of knee osteoarthritis treatment, conservative treatment and corrective osteotomies are used. Corrective osteotomies in the area of the knee joint have shown excellent results for the treatment of limited arthrosis with a predominant lesion of the medial part of the joint in relatively young patients. However, despite the good results reported in the literature, patient satisfaction usually deteriorates over time, and some inevitably require further treatment with total knee arthroplasty in cases of progression of osteoarthritis. The aim of the study. On the basis of a retrospective analysis of surgical treatment of patients with osteoarthritis of the knee joints, justify the differentiated use of surgical interventions. Materials and methods. The article considers a differentiated approach to peri-articular osteotomies and primary endoprosthesis in gonarthrosis, in particular, in the focus of the endoprosthesis selection algorithm, based on related factors, such as the stage of the disease, the patient’s age, and the presence of concomitant complications, including the presence or absence of aseptic necrosis, contractures, instability ligamentous apparatus and defects of the condyles of the tibial bone. 391 knee joints were operated on in 383 patients. Results. In general, good results were obtained in 65 % (210 people) of endoprosthetics. The patients felt well, did not feel pain, did not limp, the range of motion was restored within normal limits, there was no deformation of the joint, the axis of the limb was correct, the joint was stable. Satisfactory results were obtained in 35 % (114 people), the patients felt well, did not feel pain, moderate lameness remained, range of motion was limited to no more than 800, there was no joint deformation, the axis of the limb was correct, the joint was stable. No unsatisfactory results were obtained. Conclusions. The developed differentiated approach to operative treatment of patients with osteoarthritis of the knee joints allowed to obtain 65 % good and 35 % satisfactory results. The prospect of further development in this direction continues due to the improvement of the design of endoprostheses and the technique of surgical intervention

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“…Rehabilitation after TKA is an important challenge due to the high and during the last years' constantly increasing number of patients undergoing TKA [ 26 ]. Especially for younger patients suffering from advanced knee arthritis, aim is to increase the functional outcome and daily life activity or even the ability to return to job or sports.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation during early postoperative period following total knee arthroplasty using single-joint hybrid assistive limb as new therapy device: a randomized, controlled clinical pilot study

Mrotzek

Ahmadi

Glinski

et al. 2021

Arch Orthop Trauma Surg

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Introduction The first weeks after total knee arthroplasty (TKA) are crucial for the functional outcome. To improve knee mobility, a continuous passive motion (CPM) motor rail is commonly used during in-hospital rehabilitation. The single-joint hybrid assistive limb (HAL-SJ) is a new therapy device. The aim of the study was to improve patients’ range of motion (ROM), mobility, and satisfaction using the active-assistive support of the HAL-SJ. Materials and methods Between 09/2017 and 10/2020, 34 patients, who underwent TKA and matched the inclusion criteria, were randomized into study (HAL-SJ) and control (CPM) group. Treatment began after drain removal and was carried out until discharge. Primary outcome parameters were raised pre- and postoperatively and included the Oxford knee score (OKS), visual analog scale (VAS), and acquired range of motion. Furthermore complications caused by the device were recorded. Results OKS increased in both groups postoperatively, but only significantly in the HAL-SJ group. Postoperative pain improved in both groups without significant differences. Flexion improvement was significant in both groups between days 3/7 and 8 weeks postoperatively. We did not encounter any complications related to HAL-SJ. Conclusions In conclusion, use of the HAL-SJ during rehabilitation in the early postoperative period after TKA was safe without disadvantages compared to the control group and seems to have advantages in terms of daily life impairment.

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

Cited by 14 publications

References 33 publications

Revision arthroplasty after unicompartimental knee arthroplasty

Revision arthroplasty after unicompartimental knee arthroplasty

Surgical Treatment of Patients With Osteoarthritis of the Knee Joints

Rehabilitation during early postoperative period following total knee arthroplasty using single-joint hybrid assistive limb as new therapy device: a randomized, controlled clinical pilot study

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