allograft (transplantation) operations.^29 Surprisingly, with a total of
418,600 operations involving implantable devices, meniscus repair was
almost as common as cuff repair.
Rotator cuff repair is an even more commonly performed operation.
The rate of cuff repair was estimated to be 98 per 100,000 capita in
2006,^30 equaling an estimated 312,228 cuff repairs in 2014, if we believe
the rate has not increased. However, recent studies show a stunning growth
in the rate of rotator cuff repair, with a 353 percent increase in cuff repair
in Florida from 2000 to 2007, and a 238 percent rate increase from 1995 to
2009 in New York state. With Baby Boomers just now reaching Medicare
age, and with comprehensive proof that rotator cuffs tear around that age,
there is certain to be an explosion of cuff tear operations (all of which
entail the use of implants). A (relatively) modest 60 percent increase since
2006 would equate to 500,000 cuff repairs in the year 2014, a figure that
everyone in the orthopedic industry agrees that we have already achieved.
Shoulder stabilization surgery is usually performed on an outpatient
basis, so NIS data is unusable. Utilizing commercial databases, authors
calculated numbers of open and arthroscopic shoulder stabilization
operations in large populations (more than a tenth of the US population).
Extrapolating from these numbers, there were 30.7 shoulder stabilization
operations per 100,000 capita in 2012, or an estimated 97,928 operations
in the United States.^31 With rates growing around one patient per 100,000
in that five-year span (2008–12), there were likely 100,000 shoulder
stabilization operations in 2014, all of which require multiple surgical
implants.
Arthroscopic repair of soft tissue elements of the hip was virtually
nonexistent prior to 1990, and has been the fastest growing segment in
sports medicine since 2000. In 2014, there were approximately 100,000
hip repair operations in the United States, all of which required permanent
device implantation.^32
Cartilage implant surgery involves implantation of whole or morcelized
pieces of cartilage from one part of a patient’s body to an injured part, or
from another patient—so called “allograft cartilage” implantation. In
2016, there were 15,452 cartilage replacement operations from one
(deceased) donor to another patient.^33 With an estimated 10 percent