Shoulder instability surgery in Norway

Abstract

Background and purpose In January 2008, we established the Norwegian Register for Shoulder Instability Surgery. We report on the establishment, the baseline data, and the results at 1-year follow-up.Methods Primary and revision shoulder stabilization is reported by the surgeon on a 1-page paper form containing the patient's history of shoulder injury, clinical findings, and perioperative findings. The WOSI questionnaire for self-assessment of shoulder function is completed at baseline and at follow-up after 1, 2, and 5 years. To evaluate the completeness of registration, we compared our data with those in the Norwegian Patient Registry (NPR).Results The NPR reported 39 hospitals performing shoulder stabilizations. 20 of these started to report to our register during 2009, and 464 procedures (404 primary, 59 revisions) were included up to December 31, 2009, which represented 54% of the procedures reported to NPR. Of the 404 primary procedures, 83% were operations due to anterior instability, 10% were operations due to posterior instability, and 7% were operations due to multidirectional instability. Arthroscopic soft tissue techniques were used in 88% of the patients treated for primary anterior instability and open coracoid transfer was used in 10% of such patients. At 1-year follow-up of 213 patients, we found a statistically significantly improved WOSI score in all types of instability. 10% of the patients treated with arthroscopic anterior labral repair and 16% treated with arthroscopic posterior labral repair reported recurrent instability. No statistically significant difference in functional improvement or rate of recurrence was found between these groups.Interpretation The functional results are in accordance with those in previous studies. However, the incidence of recurrent instability 1 year after arthroscopic labral repair is higher than expected.

Spectrum of operative childhood intra-articular shoulder pathology

“…The present study of children undergoing shoulder arthroscopy compares well with another multicenter instability registry (which only included teenagers) that demonstrated 83 % anterior instability and 10 % posterior instability, although isolated posterior labral pathology in our study was slightly more common, at 16 % [8]. Thus, our findings may be generalizable to intra-articular shoulder pathology at other institutions; particularly considering that our two institutions are geographically dissimilar.…”

Safety and Effectiveness of Shoulder Arthroplasties in Spain: A Systematic Review

“…The results of the review show that shoulder arthroplasty in Spain can currently be considered an effective and safe procedure, with functional recovery and pain reduction in patients operated on for humeral fracture and rotator cuff arthropathy, fracture sequelae and malunion of the proximal humerus, and degenerative diseases. These results are similar to those found in other countries, including Norway, Germany, the Netherlands and the USA [9,15,[49][50][51], with better results observed with reverse-type arthroplasties than hemiarthroplasties.…”

“…Currently, the evidence for implant survival in Spain at the population level is limited. However, the results of the reviewed studies are similar to data from international registries, which estimate an implant revision rate of approximately 90%-95% at 5 and 10 years [9,15,49,50,52]. In addition, most of the prosthesis models identified in this review are commonly used internationally, and the ODEP assessment of most of those included in the selected studies was acceptable [9,25].…”

Do nonsteroidal anti‐inflammatory drugs affect the outcome of arthroscopic Bankart repair?

“…The present study was based on t he Norwegian shoulder instability register (Blomquist et al., 2012 ) that was established in 2008. The register includes 54% of the patients who had surgery for glenohumeral instability in Norway 1 year after start-up.…”

“…Young age predicts a high risk of recurrence and 67% of the patients below 35 years of age develop chronic instability, with new dislocations within 5 years of the primary dislocation (Robinson, 2006 ). With an annual incidence of shoulder stabilization procedures of 12 per 100 000 inhabitants in Norway (Blomquist et al., 2012 ) it is estimated that about one fourth of the patients in Norway with a traumatic dislocation end up with a surgical procedure to stabilize the shoulder joint, with a much higher proportion in the young patients.…”