In Germany, the number of joint replacement operations is increasing every year. This particularly applies to hip and knee endoprosthetics. Greater life expectancy, the desire for a high quality of life in old age and improved surgical techniques contribute significantly to this increase. But can the capacities of the health system keep pace with this boom, or are we facing a medical and social “tsunami”?

This article highlights the forecast development of joint replacement in Germany and analyzes its causes, challenges and possible solutions.

Facts and statistics: The current situation in joint replacement

Hip arthroplasty:

• In 2021, around 240,000 hip prostheses were implanted in Germany.
• A large proportion of patients suffer from coxarthrosis (hip joint osteoarthritis), a progressive degenerative disease.

Knee arthroplasty:

• Around 190,000 knee prostheses are used every year. Gonarthrosis (knee joint arthrosis) is the most common reason for these operations.

Demographic change:

• An increase of up to 30% in endoprosthetic procedures is expected by 2050, mainly due to the aging of the population.
• The number of people over 65 is expected to account for around 30% of the total population by 2040.

Causes of the predicted increase in joint replacement surgeries

Demographic development

The increasing aging of society is the main driver for the increase in operations. With age, the likelihood of degenerative joint diseases increases, which can often only be alleviated through joint replacement.

Lifestyle factors

• Obesity: Being overweight is a strong risk factor for developing osteoarthritis.
• Sports activities: An active lifestyle is healthy, but excessive strain can damage the joints.

Medical progress

• Improved surgical techniques and longer-lasting implants lead to greater acceptance of the procedures.
• Minimally invasive procedures reduce risks and shorten rehabilitation time.

Challenges caused by the increase in joint replacement surgeries

Burden on the health system

• Shortage of staff: There are already shortages in nursing and operating room staff.
• Cost explosion: The increase in procedures will put a strain on statutory health insurance contributions.

Supply shortages

• Waiting times for joint replacement surgery could increase significantly.
• Specialized centers could become overloaded.

Implant supply and overload on manufacturers

Implant manufacturers must cope with increasing demand while ensuring high quality standards are maintained.

Advances and innovations in hip and knee prostheses

Materials of the future

• New materials such as ceramic-coated implants improve durability.
• Lightweights reduce the mechanical stress on the surrounding tissue.

Digitalization and robotics in endoprosthetics

• Robot-assisted procedures enable more precise interventions.
• Artificial intelligence improves diagnostics and surgical planning.

Patient-specific implants

Implants that are individually tailored to the patient's anatomy increase the chances of success.

Prognosis for joint replacement in Germany: “The tsunami”?

The increasing demand can be compared to a tsunami as it has system-wide effects. But while the challenge is great, there are numerous ways to adapt:

• Increased capacity: Expansion of specialized centers.
• Promote prevention: Increased education can reduce the risk of osteoarthritis.
• Internationalization: Cooperation with international experts and centers.

Concrete measures to cope with increasing demand

Expansion of specialized care centers Facilities such as the Endoprotheticum Mainz can serve as a blueprint as they offer high standards and specialized expertise in endoprosthetics.

Promoting innovation Investments in new technologies and materials must be intensified.

More attractive working conditions Only through better remuneration and working conditions can the shortage of skilled personnel be eliminated in the long term.

Conclusion

The increase in joint replacements in Germany is an inevitable development. But with the right investments in prevention, innovation and infrastructure, the “tsunami” can be overcome. Specialized facilities such as the Endoprotheticum in Mainz show that specialized and patient-oriented care is the key to coping with growing demand.