treatment of knee arthritis alone in 2030 would be an astounding $61
billion dollars.
Shoulder replacement arthroplasty has ballooned at a rate over the last
fifteen years unlike any other joint over the last half century. Charlie
Neer’s original hemiarthroplasty underwent few changes throughout the
1950s and 1960s, and total shoulder replacement was still practiced by a
small subset of orthopedic surgeons in the 1980s and into the 1990s.
Throughout the 1990s, glenoid implant design had changed very little, but
at the turn of the century a major change in the shape and style of fixation
was proposed at several orthopedic implant manufacturers, both in Europe
and in America. By 2006, total shoulder replacement finally surpassed
partial shoulder replacement, and this trend has never reversed.
The number of total shoulder replacements doubled in a short few years
around the time that the FDA approved reverse total shoulder
replacements, in March 2004. This third segment has dramatically
changed (and improved) the way orthopedic surgeons address arthritis,
rotator cuff tears, fractures, and previously failed shoulder operations. Not
surprisingly, the number of reverse replacements has exponentially grown
since introduction just fifteen years ago. Combined, there were 66,485
shoulder implant operations in 2011, growing another 50 percent as this
book goes to press.^13
Elbow replacement entails either complete replacement of every
bearing surface, or simple replacement of the radial head alone. In the
United States, the annual rate of total elbow arthroplasty is 5,800 patients,
while the rate of radial head replacement is 9,200. Combined, 15,000
patients undergo some type of major implantation of metal in their elbow
every year in the United States.
Wrist and ankle replacement operations are relatively rare compared to
hip and knee arthroplasty. Instead of hundreds of thousands of cases per
year, there might be less than four hundred wrist replacement operations^14
per year in the United States. The combined total of partial and total wrist
replacement operations in 2014 was only two thousand cases.^15 Total ankle
arthroplasty is much more common, with an estimated 13,145 cases
performed over an eleven-year span, from 2000–2010.^16 There was an
increase in total ankle procedures after 2006, but the number is still likely
less than two thousand per year in the United States. Ankle fusion is much
more common (perhaps six times), and requires a substantial number of