Incidence of Partial Knee Arthroplasty

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CHAPTER 5 Incidence of Partial Knee Arthroplasty

A Growing Phenomenon?

William A. Jiranek, Daniel L. Riddle

Key Points

image Between 1998 and 2005, the incidence of partial knee replacement in the United States grew by over three times.
image As of 2005, partial knee replacement comprised approximately 9% of all knee arthroplasties in the United States.
image Most recent estimates for other countries providing public data indicate a utilization rate ranging from 8% of all arthroplasties in Great Britain and Canada to a high of 19% in Australia.
image Partial knee replacement appears to be a viable and potentially underutilized procedure worldwide.

Introduction

Because osteoarthritis of the knee is one of the most common disease processes in humans, data concerning the incidence of knee arthroplasty are important to estimate the societal cost of treatment for this condition. While utilization in countries that sponsor joint registries is well delineated, few data are available in the United States due to the lack of a national implant registry. While the Medicare databases give some idea of utilization of knee arthroplasty, partial versus total cannot be differentiated, and only patients covered by Medicare (generally greater than 65 years of age) are captured. Utilization of partial knee replacement can be considered in several ways, including as a percentage of total knee arthroplasties as well as the percentage of patients who have isolated unicompartmental arthritis. There have been previous spikes in the utilization of partial knee replacement that usually corresponded to an increase in the number of surgeons performing partial knee replacement, usually followed by a pullback related to an increase in the failure rate.

While the number of patients with symptomatic osteoarthritis has continued to grow significantly, it appears that the percentage of patients in which the osteoarthritis is confined to predominantly one compartment (and thus amenable to partial knee replacement) has remained relatively constant, and has been estimated at 30%. This chapter reports the incidence of partial knee arthroplasty (PKA) in all countries that have an existing registry. For the United States, which does not have a registry, we have estimated the incidence of unicondylar arthroplasty by indirect methods, using implant sales data from the major manufacturers.1 We have estimated market share by utilizing commercial databases that track market share.2

Growth of PKA in the United States

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