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· DOS Abstracts
Outcome and risk of revision after shoulder
replacement in patients with osteoarthritis:
1,209 cases from the Danish Shoulder
Arthroplasty Registry
Jeppe Rasmussen, Anne Polk, Anne Kathrine Belling Sørensen,
Bo Sanderhoff Olsen, Stig Brorson
Orthopaedic Surgery, Herlev Hospital
Background:
Hemiarthroplasty (HA) including resurfacing hemiarthroplasty
(RHA) and stemmed hemiarthroplasty (SHA)are widely used in Denmark but
the efficacy in comparison to that of total shoulder replacement (TSA) is poorly
documented.
Purpose / Aim of Study:
In this study we used patient reported outcome and
risk of revision to compare HA and TSA in patients diagnosed with osteoarthritis
and secondly to compare SHA and RHA.
Materials and Methods:
We included all patients reported to the Danish
Shoulder arthroplasty registry (DSR) between January 2006 and December
2010. 1209 arthroplasties in 1109 patients were eligible. Western Ontario
Osteoarthritis of the Shoulder index (WOOS) was used to evaluate patient re-
ported outcome 1 year postoperatively. For simplicity of presentation, the raw
scores were converted to a percentage of a maximum score. Revision rates were
calculated by checking reported revisions to DSR until December 2011. WOOS
and risk of revision were adjusted for age, gender, previous surgery and type of
osteoarthritis.
Findings / Results:
There were 113 TSA and 1096 HA (837 RHA and 259
SHA). Patients treated with TSA had a statistically better WOOS, exceeding the
predefined minimal clinically important difference, at one year (mean difference
10, P<0.001). RHA had a statistically significant better WOOS compared to SHA
(mean difference 5, P=0.024) but the difference did not exceed the minimal
clinically important difference. There were no statistically significant differences
in revision rate or adjusted risk of revision between any groups.
Conclusions:
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 osteoarthritis.
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