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Total knee arthroplasty in Italy: reflections from the last fifteen years and projections for the next thirty

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Abstract

Purpose

Annual rates of knee arthroplasty are increasing in all developed countries, imposing a significant economic and organizational burden; it is crucial to forecast the future need for knee arthroplasty, to assist stakeholders in planning strategies and investments, especially in a country like Italy, with the largest proportion of elderly citizens in Europe. Few epidemiological studies have been performed worldwide to estimate the demand for future knee replacement, and a variety of methods have been proposed.

Methods

We investigated the epidemiology of knee arthroplasty performed in Italy in the last 15 years and projected incidence rates up to the year 2050, utilizing, comparing, and adapting the available methodologies.

Results

From 2001 to 2016, 812,639 primary TKA were performed in Italy on patients over 40. The total number of surgeries increased by 262% with an average annual growth rate of 6.6%.

Conclusions

Adopting the best fitting projection method, an increase of 45% in incidence rate is expected for 2050.

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Acknowledgments

The authors wish to thank Mascia Masciocchi and Stefania Ceccarelli.

Funding

Francesco Decarolis thankfully acknowledges financial support from the European Research Council (ERC Starting Grant 679217).

Author information

Authors and Affiliations

  1. GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome, Italy

    Emilio Romanini, Gustavo Zanoli & Marina Torre

  2. Artrogruppo, Casa di Cura San Feliciano, Rome, Italy

    Emilio Romanini & Michele Venosa

  3. Università Bocconi, Milan, Italy

    Francesco Decarolis

  4. National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy

    Ilaria Luzi, Paola Laricchiuta, Eugenio Carrani & Marina Torre

  5. Casa di Cura Santa Maria Maddalena, Occhiobello, RO, Italy

    Gustavo Zanoli

Authors
  1. Emilio Romanini
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  2. Francesco Decarolis
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  3. Ilaria Luzi
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  4. Gustavo Zanoli
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  5. Michele Venosa
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  7. Eugenio Carrani
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  8. Marina Torre
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Contributions

Conception and design (ER, MT), acquisition of data (MT, IL, PL), statistical analysis (FD, EC), drafting of the article (ER, MT, FD, GZ, MV). All authors interpreted results, revised critically, and approved the final version of the manuscript.

Corresponding author

Correspondence to Emilio Romanini.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

The design of this study did not require any informed consent.

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Romanini, E., Decarolis, F., Luzi, I. et al. Total knee arthroplasty in Italy: reflections from the last fifteen years and projections for the next thirty. International Orthopaedics (SICOT) 43, 133–138 (2019). https://doi.org/10.1007/s00264-018-4165-7

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  • DOI: https://doi.org/10.1007/s00264-018-4165-7

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