Trends and Economic Impact of Hip and Knee Arthroplasty in Central Europe: Findings from the Austrian National Database

Arthroplasty registers were originally established in Scandinavia to receive clinically relevant information from pooled data, to improve quality and reduce revision surgeries, with socioeconomic benefit. In Austria, where the highest rate of total knee arthroplasties (TKA) per inhabitant of all OECD countries was reached in 2014, arthroplasties are centrally reported since 2009. Study purpose was to perform the first analysis of the Austrian database, aiming to obtain data on trends in arthroplasty in Austria over time in relation to demographic development. Between 2009 and 2015 an almost continuous increase of total hip arthroplasties (THA; 18.052) by 14% and TKA (17.324) by 13% were observed, representing 210 THA and 202 TKA per 100k inhabitants in 2015. A similar increase was found for revision surgeries, with 1.290 re-implanted THA (7.1% of all THA) and 919 re-implanted TKA (5.3% of all TKA) in 2015. Implantation of mega or tumor prosthesis for the knee and hip joint remained constant and was mainly performed in two university hospitals. Patellar resurfacing decreased by 31.6%. Demographic development will further increase the number of primary and revision surgeries. Inclusion of more detailed information on used and revised components was established and will improve efficacy in quality control.