The risk of revision is higher following shoulder hemiarthroplasty compared with total shoulder arthroplasty for osteoarthritis: a matched cohort study of 11,556 patients from the National Joint Registry, UK.

Publisher: Medical Journals Sweden AB Country of Publication: Sweden NLM ID: 101231512 Publication Model: Electronic Cited Medium: Internet ISSN: 1745-3682 (Electronic) Linking ISSN: 17453674 NLM ISO Abbreviation: Acta Orthop Subsets: MEDLINE

Publication: 2022- : Uppsala, Sweden : Medical Journals Sweden AB
Original Publication: Basingstoke, Hampshire, UK : Taylor & Francis, c2005-

Arthroplasty, Replacement, Shoulder*/adverse effects ; Hemiarthroplasty*/adverse effects ; Osteoarthritis*/epidemiology ; Osteoarthritis*/surgery ; Benzopyrans* ; Phenols*; Humans ; Cohort Studies ; Shoulder ; Registries ; England

Background and Purpose: Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are used in the management of osteoarthritis of the glenohumeral joint. We aimed to determine whether TSA or HA resulted in a lower risk of adverse outcomes in patients of all ages with osteoarthritis and an intact rotator cuff and in a subgroup of patients aged 60 years or younger.
Patients and Methods: Shoulder arthroplasties recorded in the National Joint Registry, UK, between April 1, 2012 and June 30, 2021, were linked to Hospital Episode Statistics in England. Elective TSAs and HAs were matched on propensity scores based on 11 variables. The primary outcome was all-cause revision. Secondary outcomes were combined revision/non-revision reoperations, 30-day inpatient complications, 1-year mortality, and length of stay. 95% confidence intervals (CI) were reported.
Results: 11,556 shoulder arthroplasties were included: 7,641 TSAs, 3,915 HAs. At 8 years 95% (CI 94-96) of TSAs and 91% (CI 90-92) of HAs remained unrevised. The hazard ratio (HR) varied across follow-up: 4-year HR 2.7 (CI 1.9-3.5), 8-year HR 2.0 (CI 0.5-3.5). Rotator cuff insufficiency was the most common revision indication. In patients aged 60 years or younger prosthesis survival at 8 years was 92% (CI 89-94) following TSA and 84% (CI 80-87) following HA.
Conclusion: The risk of revision was higher following HA in patients with osteoarthritis and an intact rotator cuff. Patients aged 60 years and younger had a higher risk of revision following HA.

Am J Epidemiol. 2006 Jun 15;163(12):1149-56. (PMID: 16624967)
BMJ Open. 2020 Aug 26;10(8):e036961. (PMID: 32847911)
Lancet. 2007 Oct 20;370(9596):1453-7. (PMID: 18064739)
JSES Int. 2020 Feb 29;4(1):95-99. (PMID: 32195469)
J Shoulder Elbow Surg. 2022 Dec;31(12):2657-2670. (PMID: 36028205)
Shoulder Elbow. 2022 Jun;14(3):238-248. (PMID: 35599710)
Osteoarthritis Cartilage. 2018 May;26(5):659-665. (PMID: 29474992)
BMJ. 2019 Feb 20;364:l298. (PMID: 30786996)
Am J Epidemiol. 2018 Aug 1;187(8):1799-1807. (PMID: 29554199)
J Clin Epidemiol. 2004 Dec;57(12):1288-94. (PMID: 15617955)
J Consult Clin Psychol. 2014 Oct;82(5):773-83. (PMID: 24731233)
Bone Joint J. 2019 Apr;101-B(4):454-460. (PMID: 30929496)
Front Pharmacol. 2019 Sep 18;10:973. (PMID: 31619986)
JSES Int. 2021 Apr 20;5(4):679-687. (PMID: 34223415)
Cochrane Database Syst Rev. 2020 Apr 21;4:CD012879. (PMID: 32315453)
J Chronic Dis. 1987;40(5):373-83. (PMID: 3558716)
Shoulder Elbow. 2016 Oct;8(4):229-40. (PMID: 27660655)
Med Care. 2005 Nov;43(11):1130-9. (PMID: 16224307)
Multivariate Behav Res. 2011 May;46(3):399-424. (PMID: 21818162)
Stat Med. 2002 Aug 15;21(15):2175-97. (PMID: 12210632)
Nephrol Dial Transplant. 2014 Jul;29(7):1362-8. (PMID: 24753459)
BMJ Open. 2016 Apr 11;6(4):e010412. (PMID: 27067892)
J Shoulder Elbow Surg. 2020 Dec;29(12):2601-2609. (PMID: 33190759)
Acta Orthop. 2018 Feb;89(1):3-9. (PMID: 29202632)

0 (theasinensin A)
0 (Benzopyrans)
0 (Phenols)

Date Created: 20240130 Date Completed: 20240131 Latest Revision: 20241023

20250114

PMC10828514

10.2340/17453674.2024.39916

38289339