Epidemiology of primary hip and knee arthroplasties in Germany: 2004 to 2008.

The objective of this study was to describe the trend in utilization of primary joint arthroplasties in Germany. Between 2004 and 2008, the number of total knee arthroplasties (TKAs) increased faster than that of total hip arthroplasties (THAs). In 2008, 159000 primary THAs and 146000 primary TKAs were performed. This represented a 15% increase in THAs and a 33% increase in TKAs compared to 2004. The annual increase in number of surgeries was 4500 for THAs and 9,000 for TKAs. Although older adults remained the main recipients of joint arthroplasties, incidence rate increased faster in non-elderly(18-64 years) compared with elderly (≥65 years) in both THAs and TKAs. Obesity, more strongly associated with TKAs than with THAs, could be a contributor to the recent steeper growth in TKAs in Germany.