Lower operating volume in shoulder arthroplasty is associated with increased revision rates in the early postoperative period: long-term analysis from the Australian Orthopaedic Association National Joint Replacement Registry

Brown, Jamie S.; Gordon, Robert J.; Peng, Yi; Hatton, Alesha; Page, Richard; Macgroarty, Kelly

doi:10.1016/j.jse.2019.10.026

Cited by 42 publications

(35 citation statements)

References 22 publications

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“…RSA accounted for only 33% of all shoulder arthroplasties in the United States as of 2011 24 ; however, as of 2017, RSA accounted for approximately 60% of all shoulder arthroplasty volume 1 . Over a similar time frame, the number of surgeons performing shoulder arthroplasty has increased sixfold 18 . The indications for RSA also have evolved, with recent evidence suggesting that 33% of all RSAs are performed for osteoarthritis, which represents the largest increase in incidence by preoperative diagnosis 1 .…”

Section: Discussionmentioning

confidence: 99%

“…The increasing role of RSA for osteoarthritis in patients with an intact rotator cuff may be related to the rates of anatomic glenoid component failure and secondary rotator cuff dysfunction observed with longitudinal follow-up after TSA [14][15][16] . Moreover, large registry studies have demonstrated higher cumulative revision rates after TSA as compared with RSA after both short-term 17 and long-term 18 follow-up.…”

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confidence: 99%

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Outcomes After Anatomic and Reverse Shoulder Arthroplasty for the Treatment of Glenohumeral Osteoarthritis

Kirsch

Puzzitiello

Swanson

et al. 2022

Journal of Bone and Joint Surgery

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Background: Reverse shoulder arthroplasty (RSA) is increasingly being utilized for the treatment of primary osteoarthritis. However, limited data are available regarding the outcomes of RSA as compared with anatomic total shoulder arthroplasty (TSA) in the setting of osteoarthritis. Methods:We performed a retrospective matched-cohort study of patients who had undergone TSA and RSA for the treatment of primary osteoarthritis and who had a minimum of 2 years of follow-up. Patients were propensity scorematched by age, sex, body mass index (BMI), preoperative American Shoulder and Elbow Surgeons (ASES) score, preoperative active forward elevation, and Walch glenoid morphology. Baseline patient demographics and clinical outcomes, including active range of motion, ASES score, Single Assessment Numerical Evaluation (SANE), and visual analog scale (VAS) for pain, were collected. Clinical and radiographic complications were evaluated.Results: One hundred and thirty-four patients (67 patients per group) were included; the mean duration of follow-up (and standard deviation) was 30 ± 10.7 months. No significant differences were found between the TSA and RSA groups in terms of the baseline or final VAS pain score (p = 0.99 and p = 0.99, respectively), ASES scores (p = 0.99 and p = 0.49, respectively), or SANE scores (p = 0.22 and p = 0.73, respectively). TSA was associated with significantly better postoperative active forward elevation (149°± 13°versus 142°± 15°; p = 0.003), external rotation (63°± 14°versus 57°± 18°; p = 0.02), and internal rotation ( ‡L3) (68.7% versus 37.3%; p < 0.001); however, there were only significant baselineto-postoperative improvements in internal rotation (gain of ‡4 levels in 53.7% versus 31.3%; p = 0.009). The overall complication rate was 4.5% (6 of 134), with no significant difference between TSA and RSA (p = 0.99). Radiolucent lines were observed in association with 14.9% of TSAs, with no gross glenoid loosening. One TSA (1.5%) was revised to RSA for the treatment of a rotator cuff tear. No loosening or revision was encountered in the RSA group.Conclusions: When performed for the treatment of osteoarthritis, TSA and RSA resulted in similar short-term patientreported outcomes, with better postoperative range of motion after TSA. Longer follow-up is needed to determine the ultimate value of RSA in the setting of osteoarthritis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Outcomes After Anatomic and Reverse Shoulder Arthroplasty for the Treatment of Glenohumeral Osteoarthritis

Kirsch

Puzzitiello

Swanson

et al. 2022

Journal of Bone and Joint Surgery

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“… 14 , 15 Studies have reported superior short-term outcome compared with hemiarthroplasty and also high risk of instability, infection, and aseptic loosening. 5 , 23 The rate of revision varies from 2.4% to 8.5%, 1 , 6 , 12 , 16 , 22 and the risk of revision due to periprosthetic joint infection is 2.4 times higher than after anatomical shoulder arthroplasty. 3 , 19 …”

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Good long-term patient-reported outcome after shoulder arthroplasty for cuff tear arthropathy

et al. 2022

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Background The use of the reverse shoulder arthroplasty (RSA) for cuff tear arthropathy (CTA) has increased within the last decades, but there is still limited information about the long-term outcome and how it performs in comparison with hemiarthroplasty (HA). The aim of this study was to compare the long-term patient-reported outcomes of RSA and HA for CTA. Methods We included all patients with CTA, who according to the Danish Shoulder Arthroplasty Registry, underwent either HA or RSA between 2006 and 2010. Patients who were alive were sent the Western Ontario Osteoarthritis of the Shoulder (WOOS) questionnaire in 2020. One hundred twenty (65%) patients returned a complete questionnaire. The linear regression model was used to compare RSA and HA. Sex, age, and previous surgery were included in the multivariable model. Results Forty-two HAs and 78 RSAs were evaluated with a mean follow-up time of 11.5 and 10.6 years, respectively. The mean WOOS score was 66.7 for HA and 71.7 for RSA. The difference of 5.0 was neither statistically significant nor clinically important (95% confidence interval: -4.3 to 14.2, P = .17), nor were there any significant risk of a worse WOOS score for sex, age, or previous surgery. Conclusion To our knowledge, this is the first study to compare the long-term patient-reported outcomes of HA and RSA for CTA. Our results indicate that RSA is a reliable and durable treatment option for CTA with good long-term results. Based on this observational study, it is not possible to make safe estimates about the effect of RSA compared with HA, but similar to RSA, HA was associated with relatively good long-term results.

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“…The distal radioulnar may be assessed depending on patient presentation.Historically, the complication rate of wrist arthroscopies is low, which has been described at up to 2% of cases. However, recent studies indicate a higher risk with up to 5.98% complication rate [5,6]. Most frequently the failure to achieve functional improvement (1.16%) and nerve lesions has been reported.…”

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confidence: 99%

“…years of experience and case load of the surgeon [6]. Furthermore, it should be noted that complications do not only occur because of the surgical procedure, but may also result from the set up.…”

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Arthroscopic Equipment and Set Up for Wrist Arthroscopy

Page

Henze

Eng

2021

Arthroscopy and Endoscopy of the Elbow, Wrist and Hand

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Wrist arthroscopy is the golden standard of diagnosing wrist disorders and used as a tool for the treatment of various pathologies. The first case was performed by M.S. Burman in 1931 and at that time no future role for arthroscopic treatment of wrist pathologies was anticipated [1]. Later, in 1971, M. Watanabe in Japan reported his first experience after 19 arthroscopies of the radiocarpal joint with a 1.7-mm diameter arthroscope due to the development of thinner arthroscopes and better light sources [2]. Thereafter, wrist arthros-copy quickly gained popularity during the 1980s and 1990s, when Terry Wipple in America and Hempfling in Germany started to pioneer more modern techniques [3,4]. Since then, arthroscopy of the radiocarpal, midcarpal and distal radioulnar joint has been used with increasing frequency for pathology in the wrist, establishing the gold standard for assessing and managing intra-articular joint-related pathology of the wrist joint.Arthroscopy of the wrist is a challenging procedure due to smaller dimensions of joint spaces and a higher risk of damage to important structures. Wrist arthroscopy includes the radiocarpal joint, the midcarpal joints and may include the distal radioulnar joint. The midcarpal joint should be inspected as a routine during wrist arthroscopy. The distal radioulnar may be assessed depending on patient presentation.Historically, the complication rate of wrist arthroscopies is low, which has been described at up to 2% of cases. However, recent studies indicate a higher risk with up to 5.98% complication rate [5,6]. Most frequently the failure to achieve functional improvement (1.16%) and nerve lesions has been reported. Other complications are injuries to tendons, arteries, tendon fistulas, carpal tunnel syndrome, compartment syndrome, stiffness, infection, cartilage lesions and complex regional pain syndrome and cysts. Another important factor is the experience of the surgeon; the risk of a complication decreases with the R. S.

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Lower operating volume in shoulder arthroplasty is associated with increased revision rates in the early postoperative period: long-term analysis from the Australian Orthopaedic Association National Joint Replacement Registry

Cited by 42 publications

References 22 publications

Outcomes After Anatomic and Reverse Shoulder Arthroplasty for the Treatment of Glenohumeral Osteoarthritis

Outcomes After Anatomic and Reverse Shoulder Arthroplasty for the Treatment of Glenohumeral Osteoarthritis

Good long-term patient-reported outcome after shoulder arthroplasty for cuff tear arthropathy

Arthroscopic Equipment and Set Up for Wrist Arthroscopy

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