Trends in High Tibial Osteotomy and Knee Arthroplasty Utilizations and Demographics in Korea From 2009 to 2013

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Abstract

We analyzed the records of 29,895 high tibial osteotomies (HTOs), 12,589 unicompartmental knee arthroplasties (UKAs) and 363,386 total knee arthroplasties (TKAs) performed from 2009 to 2013 in Korea. They were compared with the latest nationwide registry reports of seven Western countries. Over the last 5 years, in Korea, the number of HTO, UKA and TKA increased by 210%, 138%, and 18%, respectively. The largest increase was observed in 55–64 year olds in HTO and UKA, while the largest increase in TKA was in ≥ 75 year olds. Females commonly had a three- to seven-fold higher rate in all procedures. Worldwide, the use of HTO and UKA decreased or remained stable, whereas that of TKA increased steadily, even in younger patients.

Section snippets

Patients and Methods

HTO and knee arthroplasty utilization in Korea between 2009 and 2013 using the Health Insurance Review and Assessment Service (HIRA) of Korea database, and publications of nationwide TKA registries that were published after 2009 were retrospectively reviewed.

Korea has a compulsory National Health Insurance (NHI) system with universal coverage, and the HIRA, a public agency sponsored by the Ministry for Health, Welfare and Family Affairs (MIHWFA), reviews the cost of healthcare benefits and

Results

From 2009 through 2013, in total, 29,895 HTOs, 12,589 UKAs, and 363,386 primary TKAs were performed in Korea. Of these, ~ 90% of HTO and UKA were performed in a population aged 45–74 years (range, 88–91% in HTO and 90-92% in UKA) and 97% of TKA in a population aged ≥ 55 years (range, 97-98%). Additionally, ~ 77% of HTO, ~ 85% of UKA, and ~ 90% of TKA were performed on females throughout the study period. During the same period, the overall Korean civilian population increased by 3%, whereas the

Discussion

Incidence of the knee arthritis requiring surgical procedures in young active patients and the proportion of young patients undergoing TKA are increasing. Meanwhile, advances in technology and understanding of surgical technique of HTO and UKA improve their clinical outcome and survivorship, and they are being increasingly recognized as a viable treatment option for knee arthritis in young patients. However, whether these technological advances and demographic changes affect the utilization of

Acknowledgments

We thank You Soo Yeon of the Health Insurance Review and Assessment Service (HIRA) for providing the HIRA data.

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    The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2015.01.002.

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