Total knee arthroplasty in Italy: reflections from the last fifteenyears and projections for the next thirty

PurposeAnnual rates of knee arthroplasty are increasing in all developed countries, imposing a significant economic and organizational burden; it is crucial to forecast the future need for knee arthroplasty, to assist stakeholders in planning strategies and investments, especially in a country like Italy, with the largest proportion of elderly citizens in Europe. Few epidemiological studies have been performed worldwide to estimate the demand for future knee replacement, and a variety of methods have been proposed.MethodsWe investigated the epidemiology of knee arthroplasty performed in Italy in the last 15years and projected incidence rates up to the year 2050, utilizing, comparing, and adapting the available methodologies.ResultsFrom 2001 to 2016, 812,639 primary TKA were performed in Italy on patients over 40. The total number of surgeries increased by 262% with an average annual growth rate of 6.6%.ConclusionsAdopting the best fitting projection method, an increase of 45% in incidence rate is expected for 2050.