Increases in the rates of primary and revision knee replacement are reducing: a 15-year registry study across 3 continents

Figures & data

Table 1. Yearly totals of knee replacement (KR) procedures recorded in the SKAR, AOANJRR, and KPJRR

KR type ^a	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017
Sweden
Primary	8,832	9,195	9,797	10,691	10,527	11,004	12,841	12,848	12,845	13,411	13,361	13,145	12,924	14,053	14,964
Uni	982	892	928	916	728	712	693	689	594	536	494	465	648	984	1169
PF	11	16	21	9	12	17	37	31	52	43	56	58	65	52	48
Total	7,339	8,287	8,848	9,766	9,787	10,275	12,111	12,228	12,198	12,832	12,808	12,622	12,206	13,008	13,743
Revision	596	625	650	650	657	702	758	860	845	869	1002	959	936	934	945
All	9,428	9,820	10,447	11,341	11,184	11,706	13,599	13,708	13,690	14,280	14,363	14,104	13,860	14,987	15,909
Australia
Primary	26,008	7,540	30,409	31,231	33,064	36,160	37,683	40,838	43,051	44,839	46,903	49,813	53,578	55,878	59,002
Uni	4,109	3,730	3,382	3,628	2,502	3,225	3,087	2,615	2,411	21,46	2,137	2,270	2,557	3,056	3,652
PF	151	180	174	181	195	232	229	268	247	225	246	234	248	307	298
Total	21,735	23,603	26,337	27,376	29,294	32,622	34,307	37,922	40,375	42,453	44,495	47,288	50,763	52,510	55,077
Revision	2,314	2,663	2,721	2,826	2,994	3,250	3,294	3,716	3,894	3,910	4,173	4,301	4,447	4,559	4,791
All	28,322	30,203	33,130	34,057	36,058	39,410	40,977	44,554	46,945	48,749	51,076	54,114	58,025	60,437	63,793
Kaiser Permanente
Primary	4,271	5,824	7,050	8,255	9,283	10,234	10,806	12,904	13,495	14,084	15,445	17,796	18,324	20,093	20,672
Uni	144	234	210	212	200	330	448	420	371	439	522	631	602	563	579
PF	7	6	6	14	10	24	27	35	38	30	44	57	54	65	84
Total	4,120	5,584	6,834	8,029	9,073	9,880	10,331	12,449	13,086	13,616	14,879	17,109	17,669	19,465	20,009
Revision	274	363	456	556	627	773	766	850	981	1,021	1,091	1,173	1,267	1,305	1,309
All	4,545	6,187	7,506	8,810	9,910	11,007	11,572	13,754	14,476	15,106	16,536	18,969	19,592	21,398	21,981

^aUni = unicompartmental; PF = patellofemoral

Note: A small number of other primary knee replacement (unispacer, partial resurfacing, bicompartmental) are included in primary knee totals.

Figure 1. Yearly procedure volume of primary KR (left panel) and revision KR (right panel) recorded by the SKAR, AOANJRR, and KPJRR from 2003 to 2017.

Figure 2. Yearly incidence of primary KR (left panel) and revision KR (right panel) per 10⁵ population recorded by the SKAR, AOANJRR, and KPJRR from 2003 to 2017.

Figure 3. Yearly incidence of primary KR (left panel) and revision KR (right panel) by patient age < 65 and ≥ 65 years per 10⁵ population recorded by the SKAR, AOANJRR, and KPJRR from 2003 to 2017.

Figure 4. Mean 5-yearly percentage increases in procedure volume in SKAR, AOANJRR, and KPJRR.

Table 2. Yearly mean ages, percentage women, and proportion age < 65 years for primary and revision KR by registry

Factor	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017
Sweden
Primary KR
mean age	69.6	69.5	69.6	69.3	69.3	68.9	69.0	68.8	68.7	68.6	68.6	68.8	68.6	68.9	68.9
women (%)	61.0	61.9	60.0	59.5	60.0	59.3	58.3	58.4	58.2	57.7	57.0	57.2	57.0	56.0	55.7
age < 65 (%)	31.3	31.1	31.0	33.1	32.9	34.3	34.4	34.1	34.7	34.7	33.9	32.9	33.9	33.7	33.2
Revision KR
mean age	70.7	70.5	70.5	69.9	69.9	69.8	69.2	68.7	68.5	69.4	68.8	68.3	68.5	69.4	69.9
women (%)	58.2	61.0	59.2	61.5	57.5	54.0	61.1	56.6	56.1	55.5	55.5	51.9	54.2	54.6	53.2
age < 65 (%)	29.0	28.9	30.9	35.1	34.2	33.7	33.6	36.7	36.1	33.3	33.5	35.9	34.6	30.9	27.9
Australia
Primary KR
mean age	68.7	68.7	68.8	68.6	68.4	68.2	68.1	68.0	67.9	68.1	68.0	68.0	67.9	67.8	67.9
women (%)	56.3	56.8	57.2	56.6	56.9	56.5	56.5	56.3	55.9	56.1	56.4	55.7	55.4	55.5	54.8
age < 65 (%)	32.2	32.4	32.7	33.5	34.2	35.6	35.9	36.2	36.7	35.2	35.6	34.8	35.1	35.4	34.5
Revision KR
mean age	69.9	68.8	69.5	69.0	69.1	68.7	68.9	68.4	68.6	68.5	68.7	68.6	68.2	68.9	68.9
women (%)	51.6	51.8	50.5	51.5	52.7	51.9	50.8	52.2	50.7	52.3	51.2	52.4	51.3	50.0	51.1
age < 65 (%)	28.7	32.5	29.7	32.4	33.0	34.4	33.9	35.5	33.8	34.2	32.8	34.6	31.3	31.3	30.3
Kaiser Permanente
Primary KR
mean age	67.8	67.8	67.8	67.7	67.1	67.1	67.0	67.3	67.3	67.3	67.3	67.3	67.3	67.4	67.5
women (%)	64.4	63.0	64.6	63.4	62.4	61.2	61.7	60.9	61.1	60.6	61.0	60.2	61.5	60.9	60.3
age < 65 (%)	35.8	37.3	36.8	37.2	40.5	41.5	41.3	39.9	40.7	38.8	38.4	38.4	38.0	36.9	36.9
Revision KR
mean age	68.0	68.0	67.6	66.2	67.5	66.7	66.4	67.3	66.7	66.7	67.1	67.2	66.9	67.5	67.7
women (%)	48.9	54.5	53.3	55.5	53.9	52.8	58.9	55.5	53.0	57.9	53.4	56.9	56.9	53.8	54.8
age < 65 (%)	35.4	34.7	37.9	41.1	39.9	43.9	44.1	43.4	42.1	43.2	41.4	39.7	41.8	39.4	35.7