• Arch Orthop Trauma Surg · Nov 2021

    Future burden of primary and revision hip arthroplasty in Germany: a socio-economic challenge.

    • Alexander Klug, Dominik H Pfluger, Yves Gramlich, Reinhard Hoffmann, Philipp Drees, and Karl Philipp Kutzner.
    • Department of Trauma and Orthopedic Surgery, BG Unfallklinik Frankfurt Am Main, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany. alexander.klug@bgu-frankfurt.de.
    • Arch Orthop Trauma Surg. 2021 Nov 1; 141 (11): 2001-2010.

    IntroductionTotal hip arthroplasty (THA) rates have increased dramatically in the recent decades worldwide, with Germany being one of the leading countries in the prevalence of THA. Simultaneously, a rising number of revision procedures is expected, which will put an enormous economic burden on future health care systems.MethodsNationwide data provided by the Federal Statistical Office of Germany were used to quantify primary and revision arthroplasty rates as a function of age and gender. Projections were performed with use of Negative Binomial and Poisson regression models on historical procedure rates in relation to population projections from 2020 to 2060.ResultsA 62% increase in the incidence rate of primary THAs is projected until 2060. At the same time, the annual total number of revision procedures is forecast to rise about 40% by the year 2060. The highest numbers of revision arthroplasties were calculated around year 2043. The greatest proportions of revision surgery will be observed in women and in those aged 70 years or older. The revision burden is projected to stabilize around 15% by 2060.ConclusionsThe present projections allow a quantification of the increasing economic burden that (revision) THA will place on the German health care system in the upcoming decades. This study may serve as a model for other countries with similar demographic development as the country-specific approach predicts a substantial increase in the number of these procedures. This highlights the need for appropriate financial and human resource management in the future.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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