{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:39:34Z","timestamp":1793331574750,"version":"4.5.0"},"reference-count":53,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T00:00:00Z","timestamp":1594771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T00:00:00Z","timestamp":1594771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T00:00:00Z","timestamp":1594771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Total 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Comprehensive 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence rate of primary TKAs is projected to increase by around 43% to 299 per 100,000\u00a0inhabitants [95% CI 231\u2013368], leading to a projected total number of 225,957 primary TKAs in 2050 (95% CI 178,804\u2013276,442). 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.<\/jats:p>\n                    <jats:p>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\u201378,885; IR\u2009=\u200962.7 per 100,000, 95% CI 20.8\u2013104.5) procedures by 2050. Those numbers are primarily associated with a rising number of rTKAs secondary to periprosthetic joint infection (PJI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using this country\u2010 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\u2010specific 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level III, prognostic study, economic and decision analysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-020-06154-7","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T08:02:45Z","timestamp":1594800165000},"page":"3287-3298","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":301,"title":["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"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2085-1545","authenticated-orcid":false,"given":"Alexander","family":"Klug","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Trauma and Orthopedic Surgery BG Unfallklinik Frankfurt am Main Friedberger Landstr. 430 60389 Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Gramlich","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Trauma and Orthopedic Surgery BG Unfallklinik Frankfurt am Main Friedberger Landstr. 430 60389 Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Rudert","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Koenig\u2010Ludwig\u2010Haus, Julius\u2010Maximilians\u2010University Brettreichstr. 11 97074 Wuerzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Drees","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopedics University Medical Centre of the Johannes Gutenberg\u2010University of Mainz Langenbeckstra\u00dfe 1 55131 Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Trauma and Orthopedic Surgery BG Unfallklinik Frankfurt am Main Friedberger Landstr. 430 60389 Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Wei\u00dfenberger","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Koenig\u2010Ludwig\u2010Haus, Julius\u2010Maximilians\u2010University Brettreichstr. 11 97074 Wuerzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl Philipp","family":"Kutzner","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopedics University Medical Centre of the Johannes Gutenberg\u2010University of Mainz Langenbeckstra\u00dfe 1 55131 Mainz Germany"},{"name":"<!--<label>4<\/label>--> Department of Orthopaedic Surgery and Traumatology St. Josefs Hospital Wiesbaden Beethovenstr. 20 65189 Wiesbaden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,15]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010019\u20102411\u20109"},{"key":"e_1_2_10_3_2","unstructured":"AndreozziV ConteducaF IorioRet al. 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Alexander Klug or any member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent\/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Manuel Wei\u00dfenberger or any member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent\/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Reinhard Hoffmann or any member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent\/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Yves Gramlich or any member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent\/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Philipp Drees or any member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent\/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Maximilian Rudert or any member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent\/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. KarlPhilipp Kutzner or any member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent\/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No ethical approval was needed for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}