TY - THES A1 - Ibebuchi, Chibuike Chiedozie T1 - Bias correction of climate model output for Germany T1 - Bias-Korrektur des Klimamodell-Outputs für Deutschland N2 - Regional climate models (RCMs) are tools used to project future climate change at a regional scale. Despite their high horizontal resolution, RCMs are characterized by systematic biases relative to observations, which can result in unrealistic interpretations of future climate change signals. On the other hand, bias correction (BC) is a popular statistical post-processing technique applied to improve the usability of output from climate models. Like every other statistical technique, BC has its strengths and weaknesses. Hence, within the regional context of Germany, and for temperature and precipitation, this study is dedicated to the assessment of the impact of different BC techniques on the RCM output. The focuses are on the impact of BC on the RCM’s statistical characterization, and physical consistency defined as the spatiotemporal consistency between the bias-corrected variable and the simulated physical mechanisms governing the variable, as well as the correlations between the bias-corrected variable and other (simulated) climate variables. Five BC techniques were applied in adjusting the systematic biases in temperature and precipitation RCM outputs. The BC techniques are linear scaling, empirical quantile mapping, univariate quantile delta mapping, multivariate quantile delta mapping that considers inter-site dependencies, and multivariate quantile delta mapping that considers inter-variable dependencies (MBCn). The results show that each BC technique adds value in reducing the biases in the statistics of the RCM output, though the added value depends on several factors such as the temporal resolution of the data, choice of RCM, climate variable, region, and the metric used in evaluating the BC technique. Further, the raw RCMs reproduced portions of the observed modes of atmospheric circulation in Western Europe, and the observed temperature, and precipitation meteorological patterns in Germany. After the BC, generally, the spatiotemporal configurations of the simulated meteorological patterns as well as the governing large-scale mechanisms were reproduced. However, at a more localized spatial scale for the individual meteorological patterns, the BC changed the simulated co-variability of some grids, especially for precipitation. Concerning the co-variability among the variables, a physically interpretable positive correlation was found between temperature and precipitation during boreal winter in both models and observations. For most grid boxes in the study domain and on average, the BC techniques that do not adjust inter-variable dependency did not notably change the simulated correlations between the climate variables. However, depending on the grid box, the (univariate) BC techniques tend to degrade the simulated temporal correlations between temperature and precipitation. Further, MBCn which adjusts biases in inter-variable dependency has the skill to improve the correlations between the simulated variables towards observations. N2 - Regionale Klimamodelle (RCMs) sind Werkzeuge, die verwendet werden, um den zukünftigen Klimawandel auf regionaler Ebene zu prognostizieren. Trotz ihrer hohen horizontalen Auflösung sind RCMs je nach Beobachtung durch systematische Verzerrungen gekennzeichnet, was zu unrealistischen Interpretationen zukünftiger Signale des Klimawandels führen kann. Andererseits ist die Bias-Korrektur (BC) eine beliebte statistische Nachbearbeitungstechnik, die angewendet wird, um die Nutzbarkeit der Ergebnisse von Klimamodellen zu verbessern. Wie jede andere statistische Technik hat BC seine Stärken und Schwächen. Daher widmet sich diese Studie im regionalen Kontext Deutschlands und für Temperatur und Niederschlag der Bewertung der Auswirkungen verschiedener BC-Techniken auf den das RCM-ErtragErgebnis. Die Schwerpunkte liegen auf der Auswirkung von BC auf die statistische Charakterisierung des RCM und auf der physikalischen Konsistenz. Letztere ist, definiert als die räumlich-zeitliche Konsistenz zwischen der systematisch korrigierten Variablen und den simulierten physikalischen Mechanismen, die diese Variable steuern, sowie auf den Korrelationen zwischen der systematisch korrigierten Variablen und anderen (simulierten) Klimavariablen. Fünf BC-Techniken wurden angewendet, um die systematischen Abweichungen in den Temperatur- und Niederschlags-RCM-Ausgaben Ergebnissen anzupassen. Die BC-Techniken sind lineare Skalierung, empirisches Quantil-Mapping, univariates Quantil-Delta-Mapping, sowie multivariates Quantil-Delta-Mapping, das Abhängigkeiten zwischen Standorten berücksichtigt, und multivariates Quantil-Delta-Mapping, das intervariable Abhängigkeiten (MBCn) berücksichtigt. Die Ergebnisse zeigen, dass jede BC-Technik einen Mehrwert bei der Reduzierung der Verzerrungen in den Statistiken der RCM-Ausgabe bringt, und dies, obwohl der Mehrwert von mehreren Faktoren abhängt, wie der zeitlichen Auflösung der Daten, der Wahl der RCM, der Klimavariable, der Region und desr verwendeten Massstabsetrik zur Bewertung der BC-Technik verwendet. Darüber hinaus reproduzierten die rohen RCMs Teile der beobachteten Modi der atmosphärischen Zirkulation in Westeuropa und die beobachteten meteorologischen Temperatur- und Niederschlagsmuster in Deutschland. Nach der BC wurden im Allgemeinen die raumzeitlichen Konfigurationen der simulierten meteorologischen Muster sowie die maßgeblichen großräumigen Mechanismen reproduziert. Auf einer stärker lokalisierten räumlichen Skala änderte der BC jedoch für die einzelnen meteorologischen Muster die simulierte Kovariabilität einiger Gitter, insbesondere für Niederschlag. Bezüglich der Kovariabilität zwischen den Variablen wurde sowohl in Modellen als auch in Beobachtungen eine physikalisch interpretierbare positive Korrelation zwischen Temperatur und Niederschlag im borealen Winter gefunden. Für die meisten Gitterboxen Gitterfelder im Untersuchungsbereich und auch im Durchschnitt änderten die BC-Techniken, die die Abhängigkeit zwischen den Variablen nicht anpassen, die simulierten Korrelationen zwischen den Klimavariablen nicht merklich. Allerdings neigen die (univariaten) BC-Techniken je nach Gitterbox Gitterfeld dazu, die simulierten zeitlichen Korrelationen zwischen Temperatur und Niederschlag zu verschlechtern. Darüber hinaus hat MBCn, das Verzerrungen in der Abhängigkeit zwischen Variablen anpasst, die Fähigkeit, die Korrelationen zwischen den simulierten Variablen gegenüber den Beobachtungen zu verbessern. KW - Bias correction KW - regional climate models KW - Germany KW - physical consistency KW - meteorological patterns KW - Bias-Korrektur KW - Regionale Klimamodelle KW - Deutschland KW - Physikalische Konsistenz KW - Meteorologische Muster Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-312647 ER - TY - JOUR A1 - Parisi, Sandra A1 - Lehner, Nina A1 - Schrader, Hanna A1 - Kierer, Leonard A1 - Fleischer, Anna A1 - Miljukov, Olga A1 - Borgulya, Gabor A1 - Rüter, Gernot A1 - Viniol, Annika A1 - Gágyor, Ildikó T1 - Experiencing COVID-19, home isolation and primary health care: A mixed-methods study JF - Frontiers in Public Health N2 - Objectives Although the vast majority of COVID-19 cases are treated in primary care, patients' experiences during home isolation have been little studied. This study aimed to explore the experiences of patients with acute COVID-19 and to identify challenges after the initial adaptation of the German health system to the pandemic (after first infection wave from February to June 2020). Methods A mixed-method convergent design was used to gain a holistic insight into patients experience. The study consisted of a cross-sectional survey, open survey answers and semi-structured telephone interviews. Descriptive analysis was performed on quantitative survey answers. Between group differences were calculated to explore changes after the first infection wave. Qualitative thematic analysis was conducted on open survey answers and interviews. The results were then compared within a triangulation protocol. Results A total of 1100 participants from all German states were recruited by 145 general practitioners from August 2020 to April 2021, 42 additionally took part in qualitative interviews. Disease onset varied from February 2020 to April 2021. After the first infection wave, more participants were tested positive during the acute disease (88.8%; 95.2%; P < 0.001). Waiting times for tests (mean 4.5 days, SD 4.1; 2.7days, SD 2.6, P < 0.001) and test results (mean 2.4 days, SD 1.9; 1.8 days, SD 1.3, P < 0.001) decreased. Qualitative results indicated that the availability of repeated testing and antigen tests reduced insecurities, transmission and related guilt. Although personal consultations at general practices increased (6.8%; 15.5%, P < 0.001), telephone consultation remained the main mode of consultation (78.5%) and video remained insignificant (1.9%). The course of disease, the living situation and social surroundings during isolation, access to health care, personal resilience, spirituality and feelings of guilt and worries emerged as themes influencing the illness experience. Challenges were contact management and adequate provision of care during home isolation. A constant contact person within the health system helped against feelings of care deprivation, uncertainty and fear. Conclusions Our study highlights that home isolation of individuals with COVID-19 requires a holistic approach that considers all aspects of patient care and effective coordination between different care providers. KW - COVID-19 KW - patients' experience KW - illness experience KW - mixed methods KW - general practice KW - home isolation KW - Germany KW - telehealth Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-301498 SN - 2296-2565 VL - 10 ER - TY - JOUR A1 - Gottschlich, Günter A1 - Drenckhahn, Detlev A1 - Meierott, Lenz A1 - Zonneveld, Ben T1 - Hieracium maculatum subsp. pseudogougetianum, eine neue Unterart aus dem Mainfränkischen Muschelkalkgebiet T1 - Hieracium maculatum subsp. pseudogougetianum, a new subspecies from the Main-Franconian shell-bearing limestone area JF - Forum Geobotanicum N2 - In Lower Franconia/Northern Bavaria, a well-defined subspecies of the Hieracium maculatum group was detected. This subspecies is restricted to the slopes of the Main valley between Würzburg and Hasloch with a hot spot (>90% of total population) between the villages Thüngersheim and Retzbach. Due to some similarities with H. glaucinum subsp. prasiophaeum (synonym: subsp. gougetianum) the subspecies is named H. maculatum subsp. pseudogougetianum. This subspecies grows preferentially on shell-bearing limestone gravels and begins flowering as early as mid-April. Head involucra are whitish hairy mixed with dark stalked glands. The basal leaf rosette consists of ovate to elliptic, toothed to serrate, dark spotted leaves, glabrous, glaucous above. Stems bear 1-3(4) stalked stem leaves and usually form long lateral flowering branches from the leaf axils. Like some other H. maculatum subspecies, H. maculatum subsp. pseudogougetianum is tetraploid with a mean genome weight (2C value) of 14.5 pg, distinguishing it from the H. glaucinum group, whose studied taxa are invariably triploid (mean 10.1 pg). N2 - In Unterfranken/Nordbayern wurde eine gut abgegrenzte Unterart der Hieracium maculatum-Gruppe festgestellt, die auf die Hänge des Maintals zwischen Würzburg und Hasloch beschränkt ist mit einem Hot Spot (>90% des Gesamtbestandes) zwischen den Orten Thüngersheim und Retzbach. Aufgrund einiger Ähnlichkeiten mit H. glaucinum subsp. prasiophaeum (Syn.: subsp. gougetianum) wird die Unterart als H. maculatum subsp. pseudogougetianum beschrieben. Diese Subspecies wächst bevorzugt auf Muschelkalk-Schotter und beginnt bereits Mitte April zu blühen, hat weißlich behaarte Kopfhüllen mit dunklen Stieldrüsen. Die Grundblattrosette besteht aus eiförmigen bis elliptischen, gezähnten bis gesägten, oberseits kahlen, glauken und dunkel gefleckten Blättern. Die Stängel tragen 1-3(4) gestielte Laubblätter und bilden meistens lange blühende Seitenäste aus den Blattachseln. H. maculatum subsp. pseudogougetianum ist wie ein Teil der H. maculatum-Sippen tetraploid mit einem Genomgewicht (2C-Wert) von 14,5 pg und unterscheidet sich damit von der H. glaucinum-Gruppe, deren untersuchte Taxa ausnahmslos triploid sind (10,1 pg). KW - Asteraceae KW - Hieracium maculatum KW - new subspecies KW - Northern Bavaria KW - Germany KW - Korbblütler KW - Habichtskraut KW - Unterart KW - Bayern (Nord) Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-327601 UR - http://forum-geobotanicum.net/articles/vol_11-2023/GG-DD-LM-BZ_H-pseudogougetianum_pp15-20/FG---GG-DD-LM-BZ_H-pseudogougetianum.pdf SN - 1867-9315 VL - 11 ER - TY - JOUR A1 - Drenckhahn, Detlev A1 - Gottschlich, Günter A1 - Zonneveld, Ben T1 - Neubeschreibungen und 2C-Werte von Pilosella macranthela subsp. silvae-pici (Spessart-Mausohrhabichtskraut) und Pilosella ottonis (Otto-Mausohrhabichtskraut) mit einer Übersicht über das Vorkommen von P. macranthela-Taxa in Bayern. T1 - New descriptions and 2C-values of Pilosella macranthela subsp. silvae-pici (Spessart mouse-ear hawkweed) and Pilosella ottonis (Otto mouse-ear hawkweed) with an overview of the occurrence of P. macranthela taxa in Bavaria. JF - Forum Geobotanicum N2 - A pentaploid taxon from the Pilosella macranthela group was discovered in Lower Franconia/Bavaria which is newly described here as P. macranthela subsp. sylvae-pici. It grows mainly in the Bavarian Bunter Spessart and occurs with three small, isolated stands also in the limestone area of the Main valley and Tauber area. Its habit of growth is intermediate between the furcata and laxicephala types of Pilosellae with epigeal and partly hypogeal stolons and a tendency to form clusters. The upper and lower surfaces of the rosette leaves have stellate hairs. The peduncles and the phyllaries are densely covered with dark glandular hairs with yellowish glandular heads. The lateral teeth of the ligules often are separated by incisions. A tetra- und pentaploid transitional taxon between P. macranthela subsp. sylvae-pici and P. officinarum is described as P. ottonis. P. ottonis is tetra- and pentaploid with up to 7 capitula. It is densely covered with dark stalk glands on phyllaries and resembles forms of P. acutifolia in habit. The phyllaries of P. ottonis are covered with numerous epidermal papillae with a diameter of about 10–20 μm and in this aspect resemble P. macranthela subsp. sylvae-pici and P. glomerata. However, in P. officinarum epidermal papillae are absent. Plants of genetically heterogeneous tetra- and heptaploid P. macranthela have been found outside the Spessart as spontaneous hybrids between P. glomerata and P. officinarum and also occur sporadically without P. glomerata in the vicinity. N2 - Eine pentaploide Sippe aus der Pilosella macranthela-Verwandtschaft wurde in Unterfranken/Bayern entdeckt, die hier als P. macranthela subsp. sylvae-pici neu beschrieben wird. Sie wächst hauptsächlich im bayerischen Buntsandstein-Spessart und kommt mit drei kleinen, isolierten Wuchsorten auch in den Kalkgebieten des Maintals und Tauberbereichs vor. Die Wuchsform steht zwischen dem Furcata- und Laxicephala-Typus von Pilosellinen mit ober- und teils unterirdischen Ausläufern und zeigt Neigung, Horste zu bilden. Die Ober- und Unterseiten der Rosettenblätter besitzen Sternhaare. Die Korbstiele und Hüllblätter sind dicht mit dunkel gestielten Drüsenhaaren mit gelblichen Drüsenköpfen besetzt. Die seitlichen Zähne der Blütenzungen sind oft durch Einschnitte abgetrennt. Tetra- und pentaploide Zwischenarten zwischen P. macranthela subsp. sylvae-pici und P. officinarum werden als P. ottonis neu beschrieben. P. ottonis ist tetra- und pentaploid mit bis zu 7 Körben, ist an den Hüllblättern mit dunklen Stieldrüsen besetzt und ähnelt vom Habitus Formen von P. acutlifolia. Die Hüllen von P. ottonis besitzen wie die von P. macranthela subsp. sylvae-pici und P. glomerata zahlreiche, ca. 10–20 μm dicke Epidermispapillen, die stets bei P. officinarum fehlen. Heterogene P. marcanthela-Sippen (tetra- und heptaploid) kommen als Spontanhybride zwischen P. glomerata und P. officinarum auch außerhalb des Spessartgebiets vor und wurden auch ohne benachbarte P. glomerata gefunden. KW - Asteraceae KW - Pilosella macranthela KW - cytotopes KW - 2C-values KW - Bavaria KW - Habichtskraut KW - Pilosella ottonis KW - Germany Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-344797 UR - http://forum-geobotanicum.net/articles/vol_11-2023/DD-GG-BZ_Neubeschreibungen_pp21-34/FG---DD-GG-BZ_Neubeschreibungen-P_macranthela-P_ottonis.pdf SN - 1867-9315 VL - 11 ER - TY - JOUR A1 - Gottschlich, Günter T1 - Hieracium rotundatum subsp. silvae-bavaricae, eine neue Hieracium-Sippe aus dem Bayerischen Wald (Deutschland) T1 - Hieracium rotundatum subsp. silvae-bavaricae, a new Hieracium taxon from the Bavarian Forest (Germany) JF - Forum Geobotanicum N2 - Hieracium rotundatum subsp. silvae-bavaricae is described as new for science and illustrated. The new subspecies belongs to a group of species (H. rotundatum, H. transylvanicum) whose main distribution is in the Balkans. The changeful nomenclatural history of the species name is described. Diagnostic features to distinguish the growth habit-similar species H. murorum, H. rotundatum and H. transylvanicum are discussed. Particular attention is drawn to the importance of the development of the basic leaf cycle. Contrary to previous knowledge, the northwestern distribution limit of H.rotundatum extends now to southeastern Bavaria. During the search for H. rotundatum a morphologically conspicuous subspecies of H. rotundatum could be detected, which is described here as new. N2 - Hieracium rotundatum subsp. silvae-bavaricae wird als neu für die Wissenschaft beschrieben und abgebildet. Die neue Unterart gehört zu einem Formenkreis von Arten (H. rotundatum, H. transylvanicum), dessen Hauptverbreitung auf dem Balkan liegt. Die wechselvolle nomenklatorische Geschichte des Artnamens wird nachgezeichnet. Diagnostische Merkmale zur Unterscheidung der in der Wuchsform ähnlichen Arten H. murorum, H. rotundatum und H. transylvanicum werden diskutiert. Dabei wird auf die Bedeutung der Ausbildung des Grundblattzyklus besonders hingewiesen. Entgegen bisheriger Kenntnis reicht die nordwestliche Verbreitungsgrenze von H. rotundatum nun bis Südost-Bayern. Bei der Suche nach H. rotundatum konnte auch eine morphologisch auffällige Unterart von H. rotundatum nachgewiesen werden, die hier als neu beschrieben wird. KW - Germany KW - Bavaria KW - new subspecies KW - Hieracium KW - Habichtskraut KW - Korbblütler Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-327145 UR - http://forum-geobotanicum.net/articles/vol_11-2023/Gottschlich_H-silvae-bavaricae_pp8-14/FG---Gottschlich_H-silvae-bavaricae.pdf SN - 1867-9315 VL - 11 ER - TY - JOUR A1 - Goldan, Lea A1 - Jaksztat, Steffen A1 - Gross, Christiane T1 - How does obtaining a permanent employment contract affect the job satisfaction of doctoral graduates inside and outside academia? JF - Higher Education N2 - Previous research has shown that temporary employment is negatively associated with many psychological and job-related outcomes, such as well-being, health, wages, organisational commitment, and job satisfaction. Among recent doctoral graduates, the proportion of temporary contracts is particularly high. However, research on the association between contract type and job satisfaction specifically among doctoral graduates is scarce. Therefore, whether and how obtaining permanent employment affects doctoral graduates’ job satisfaction remains a notable research gap that we intend to narrow by using panel data from a recent doctoral graduation cohort and by adopting a panel research design. We examine what effect obtaining permanent employment has on doctoral graduates’ job satisfaction and whether this effect differs by labour market sector. We use panel data that are representative of the 2014 doctoral graduation cohort in Germany and their career trajectories up to five years after graduation. We apply fixed-effects regression to approximate the within-effect of obtaining a permanent employment contract on job satisfaction. The analyses indicate that obtaining permanent employment increases doctoral graduates’ job satisfaction and that this increase is not driven by time-varying confounders. We also find that doctoral graduates’ labour market sector moderates the effect: the increase in job satisfaction is highest in the academic sector and statistically significantly different from that in the private sector. Overall, this paper offers new insights into the effect of obtaining a permanent contract on the job satisfaction of recent doctoral graduates throughout their first years after graduation, when they are often employed on temporary contracts. KW - permanent employment KW - temporary employment KW - job satisfaction KW - doctoral graduates KW - Germany Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324766 SN - 0018-1560 VL - 86 IS - 1 ER - TY - JOUR A1 - Heinz, Tizian A1 - Eidmann, Annette A1 - Jakuscheit, Axel A1 - Laux, Tino A1 - Rudert, Maximilian A1 - Stratos, Ioannis T1 - Demographics and trends for inbound medical tourism in Germany for orthopedic patients before and during the COVID-19 pandemic JF - International Journal of Environmental Research and Public Health N2 - Medical tourism is a rapidly growing sector of economic growth and diversification. However, data on the demographics and characteristics of the traveling patients are sparse. In this study, we analyzed the common demographic properties and characteristics of the inbound medical tourists seeking orthopedic medical care in Germany for the years 2010 to 2019 compared to a domestic group. At the same time, we examined how the COVID-19 pandemic outbreak of 2020 changed the field of medical tourism in Germany. Calculations were performed using administrative hospital data provided by the Federal Statistical Department of Germany. Data were analyzed from the years 2010 to 2020. A total of six elective orthopedic surgery codes (bone biopsy, knee arthroplasty, foot surgery, osteotomy, hardware removal, and arthrodesis) were identified as key service indicators for medical tourism and further analyzed. Factors including residence, sex, year, and type of elective surgery were modeled using linear regression analysis. Age and sex distributions were compared between patients living inside Germany (DE) or outside Germany (non-DE). Between 2010 and 2020, 6,261,801 orthopedic procedures were coded for the DE group and 27,420 key procedures were identified for the non-DE group. Medical tourists were predominantly male and significantly younger than the domestic population. The linear regression analysis of the OPS codes over the past years showed a significantly different slope between the DE and non-DE groups only for the OPS code “hardware removal”. With the COVID-19 pandemic, an overall decline in performed orthopedic procedures was observed for the non-DE and the DE group. A significant reduction below the 95% prediction bands for the year 2020 could be shown for hardware removal and foot surgery (for DE), and for hardware removal, knee arthroplasty, foot surgery, and osteotomy (for non-DE). This study is the first to quantify inbound medical tourism in elective orthopedic surgery in Germany. The COVID-19 pandemic negatively affected many — but not all — areas of orthopedic surgery. It has to be seen how this negative trend will develop in the future. KW - inbound medical tourism KW - orthopedic surgery KW - Germany KW - COVID-19 KW - pandemic Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-304955 SN - 1660-4601 VL - 20 IS - 2 ER - TY - JOUR A1 - Heinz, Tizian A1 - Eidmann, Annette A1 - Anderson, Philip A1 - Weißenberger, Manuel A1 - Jakuscheit, Axel A1 - Rudert, Maximilian A1 - Stratos, Ioannis T1 - Trends in computer-assisted surgery for total knee arthroplasty in Germany: an analysis based on the operative procedure classification system between 2010 to 2021 JF - Journal of Clinical Medicine N2 - Alignment strategies for primary total knee arthroplasty (TKA) have changed significantly over time with a shift towards a more individualized alignment goal. At the same time, computer-assisted surgery (CAS) has gained interest for intraoperative control and accuracy in implant positioning and limb alignment. Despite the often discussed benefits and drawbacks of robotics and navigation for TKA, the routine use of these new devices on a day-to-day basis remains obscure. Therefore, nationwide hospital billing data based on the Operation Procedure Classification System (OPS) were retrieved from the Federal Statistical Office of Germany for the period from 2010 to 2021. OPS codes for primary total knee arthroplasty (OPS code: 5-822*) were further analyzed regarding the usage of computer navigation (additional OPS code: 5-988) or robotic devices (additional OPS code: 5-987). Gender and age at the time of surgery were also assessed. The results show a total of 2,226,559 primary TKAs were implanted between 2010 and 2021, of which 2,044,914 were performed conventionally (91.84% of all TKAs). A total of 170,276 TKAs were performed using navigation technique (7.65% of all TKAs) and another 11,369 TKAs were performed using robotics (0.51% of all TKAs). For the period from 2018 to 2021, a substantial increase in robot-assisted TKA (R-TKA) was observed, with an average increase rate of 84.74% per year, while the number of navigated TKAs declined (−3.67% per year). Computer-assisted surgery, and particularly robotics for TKA, are seeing growing popularity and stepwise translation into routine clinical use in Germany, with a steep increase rate of more than 80% per year since 2018. Nevertheless, the majority of TKAs are still performed using manual instrumentation, rendering conventional TKA the currently unchanged gold standard. KW - robotic KW - TKA KW - knee replacement KW - computer navigation KW - Germany Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-304879 SN - 2077-0383 VL - 12 IS - 2 ER -