X-ref For other Roundups in this issue that cross-reference with Knee see: Trauma Roundup 2; Oncology Roundup 8; Research Roundups 2, 3, 4, 6 and 7.
The rising burden of knee arthroplasty
The increasing burden of osteoarthritis in an ageing population is well known, and despite a plethora of doom-mongering predictive papers a few years ago, there has been little in the recent literature to confirm if the rising tide is indeed, as they claim, rising! An epidemiology team in Melbourne (Australia)1 have published one of the first studies to accurately quantify this increase. The major strength of this paper is in quite how comprehensive the dataset is, the investigators having reviewed data from Australia, Demark, Finland, Norway and Sweden. They used the long-standing and established population registries in these countries to compare the lifetime risk of primary total knee arthroplasty (TKA) for osteoarthritis (OA) in five countries, and to describe a change in lifetime risk over a ten-year period.
The incidence of TKAs performed annually in patients aged 60 years or younger increased over the study period in all countries by up to 5.1%. The proportion of TKAs performed for those patients aged 80 years or older decreased over the ten-year period in all countries except Finland. TKA was most frequently performed for the 60 to 69 years age group at the end of the study period in 2013. The lifetime risk varied across all countries included in the study from 5.84% (Denmark) to 19.2% (Finland).
The considerable data presented in this paper comprehensively assess the increasing burden of TKA in a range of developed countries, providing an important and sanitising review for all those responsible for planning healthcare budgets. In the face of tightening financial controls, decisions have to be made about this increasing demand. Difficult decisions are clearly looming and these will …