title: Utilization rates of knee-arthroplasty in OECD countries.
abstract: BACKGROUND
  The number of knee arthroplasties and the prevalence of obesity are increasing exponentially. To date there have been no published reviews on utilization rates of knee arthroplasty in OECD countries.
  
  
  METHODS
  We analysed economic, medical and population data relating to knee arthroplasty surgeries performed in OECD countries. Gross domestic product (GDP), health expenditures, obesity prevalence, knee arthroplasty utilization rates and growth in knee arthroplasty rates per 100,000 population were assessed for total population, for patients aged 65 years and over, and patients aged 64 years and younger.
  
  
  RESULTS
  Obesity prevalence and utilization of knee arthroplasty have increased significantly in the past. The mean utilization rate of knee arthroplasty was 150 (22-235) cases per 100,000 total population in 2011. The strongest annual increase (7%) occurred in patients 64 years and under. Differences between individual countries can be explained by economic and medical patterns, with countries with higher medical expenditures and obesity prevalence having significantly higher utilization rates. Countries with lower utilization rates have significantly higher growth in utilization rates. The future demand for knee prostheses will increase x-fold by 2030, with exact rates dependant upon economic, social and medical factors.
  
  
  CONCLUSIONS
  We observed a 10-fold variation in the utilization of knee arthroplasty among OECD countries. A significant and strong correlation of GDP, health expenditures and obesity prevalence with utilization of knee arthroplasty was found. Patients aged 64 years and younger show a two-fold higher growth rate in knee arthroplasty compared to the older population. This trend could result in a four-fold demand for knee arthroplasty in OECD countries by 2030.
authors.affiliation: EFORT-EAR (European Arthroplasty Register) Scientific Office, Medical University of Innsbruck, Austria; Medical University of Graz, OPZ Graz, Plüddemanngasse 45, 8010 Graz, Austria. Electronic address: pabinger@opz.at.
authors.forename: C
authors.initials: C
authors.lastname: Pabinger
authors.affiliation: Medical University of Graz, OPZ Graz, Plüddemanngasse 45, 8010 Graz, Austria; University of Music and Performing Arts Graz, Fischergasse 14/II/12, 8010 Graz, Austria. Electronic address: harald@lothaller.net.
authors.forename: H
authors.initials: H
authors.lastname: Lothaller
authors.affiliation: Department of Health Care Management, WHO Collaborating Centre for Health Systems Research and Management, Berlin University of Technology, Straße des 17. Juni 135, H80 10623 Berlin, Germany. Electronic address: a.geissler@tu-berlin.de.
authors.forename: A
authors.initials: A
authors.lastname: Geissler
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D059066:Gross Domestic Product; D005102:Health Expenditures; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D066150:Organisation for Economic Co-Operation and Development; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000601:surgery*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; Knee arthroplasty; Knee prostheses; OECD; Utilization