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Register studies

Patient-reported outcome and risk of revision after shoulder replacement for osteoarthritis

1,209 cases from the Danish Shoulder Arthroplasty Registry, 2006–2010

, , , &
Pages 117-122 | Received 03 Jul 2013, Accepted 06 Jan 2014, Published online: 20 Mar 2014
 

Abstract

Purpose — We used patient-reported outcome and risk of revision to compare hemiarthroplasty (HA) with total shoulder arthroplasty (TSA) and stemmed hemiarthroplasty (SHA) with resurfacing hemiarthroplasty (RHA) in patients with glenohumeral osteoarthritis.

Patients and methods — We included all patients reported to the Danish Shoulder Arthroplasty Registry (DSR) between January 2006 and December 2010. 1,209 arthroplasties in 1,109 patients were eligible. Western Ontario Osteoarthritis of the Shoulder index (WOOS) was used to evaluate patient-reported outcome 1 year postoperatively. For simplicity of presentation, the raw scores were converted to a percentage of the maximum score. Revision rates were calculated by checking reported revisions to the DSR until December 2011. WOOS and risk of revision were adjusted for age, sex, previous surgery, and type of osteoarthritis.

Results — There were 113 TSAs and 1096 HAs (837 RHAs and 259 SHAs). Patients treated with TSA generally had a better WOOS, exceeding the predefined minimal clinically important difference, at 1 year (mean difference 10, p < 0.001). RHA had a better WOOS than SHA (mean difference 5, p = 0.02), but the difference did not exceed the minimal clinically important difference. There were no statistically significant differences in revision rate or in adjusted risk of revision between any of the groups.

Interpretation — Our results are in accordance with the results from other national shoulder registries and the results published in systematic reviews favoring TSA in the treatment of glenohumeral osteoarthritis. Nonetheless, this registry study had certain limitations and the results should be interpreted carefully.

JR: conception and design of the study, data processing, statistics, writing of the paper, and incorporation of input from the other authors; AP: collection of data, data processing, and review of the manuscript; SB and AKS: writing of the paper and interpretation; BO: conception and design of the study, interpretation, and review of the manuscript.

We thank Tobias Wirenfeldt Klausen for statistical advice and the Danish orthopedic surgeons for data reporting.

No competing interests declared.