Prevalence of Hip and Knee Arthroplasty

  • Florian Rothbauer
  • Ute Zerwes
  • Hans-Holger Bleß
  • Miriam Kip
Open Access


The annual rate of primary hip and knee arthroplasty has not increased since 2007. In the 70 years plus age group, the rate of primary hip arthroplasty was 1.1 % (in both 2007 and 2014) and the rate of primary knee arthroplasty was 0.7 % in 2007 and 0.6 % in 2014. In 2014, the prevalence of surgery in relation to the entire population was 0.26 % for the hip and 0.19 % for the knee. Approximately 219,000 primary hip replacements and 149,000 primary knee replacements were documented in Germany in 2014. The most common procedure performed on a joint was total replacement. Approximately 40 % of all primary hip or knee replacements are performed in patients in the 70 to 79 year age group; women are more frequently affected than men (ratio 2:1). In 2014, the absolute number of revisions (including revisions without replacements) amounted to approximately 30,000 for the hip and 20,000 for the knee. The number of revisions performed in any given year is not necessarily directly related to the number of primary replacements performed in the same year. Instead, the number of revisions should be considered in relation to the cumulative number of primary replacements performed over the past years and decades. As with primary arthroplasty, approximately 40 % of the revisions are performed on patients in the 70 to 79 years age group. However, the difference between men and women is less pronounced.

Between 2007 and 2014, the rate of hip and knee revision replacements (including revision without replacements) also remained stable. In 2014, in the 70 years plus age group, the rate of revision replacements (including revision without replacements) was 0.19 % for the hip and 0.10 % for the knee. The annual utilization rate of primary hip and knee arthroplasty varies internationally. Regional differences also exist within Germany itself, as evaluations conducted by the statutory health insurances for the period from 2005 to 2011 have shown. A comparatively low utilization rate was associated in particular with low incidences of osteoarthritis, low social status, a high number of regional specialist physicians (orthopedists) and patients living in urban areas.


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Authors and Affiliations

  • Florian Rothbauer
    • 1
  • Ute Zerwes
    • 1
  • Hans-Holger Bleß
    • 2
  • Miriam Kip
    • 2
  1. 1.AiM GmbH - Assessment in Medicine, Research and ConsultingLörrachGermany
  2. 2.IGES Institut GmbHBerlinGermany

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