Swedish Shoulder Arthroplasty Registry

Educational Objectives

The goal of this lecture is to recognize trends in shoulder arthroscopy. After hearing and assimilating this lecture, the clinician will be better able to:

1. Report trends in shoulder arthroscopy as reflected in
the Swedish Registry data.

Summary

Arthroplasty: total shoulder arthroplasty (TSA) now overtaking hemiarthroplasty (HA); use of reverse TSA increasing rapidly over last 3 to 4 yr; total number of TSA (conventional and reverse) increasing in patients <50 yr of age; resurfacing rarely performed; reverse TSA replacing HA for management of acute complex fractures

Survivorship: revision rate for TSA 2.5%; revision rate for reverse TSA 4.8%; survivorship of both constructs at 15 yr >90%; no improvement seen in survival with TSA over time; survival curve improving over time for reverse TSA (associated with decreasing revision rate); reasons for revision — instability and loosening most common for reverse TSA; loosening most common for TSA; resurfacing performed most commonly for glenoid pain as HA; revision rate for resurfacing 9%

Outcome: on 5- and 10-yr outcome questionnaires, greater functional improvement seen over time with TSA than with reverse TSA; both show slight deterioration in function at 5- and 10-yr marks; HA and resurfacing remained constant

Readings

Favard L et al: Reverse prostheses in arthropathies with cuff tear: are survivorship and function maintained over time? Clin Orthop Relat Res, 2011 Sep;469(9):2469-75; Kim SH et al: Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am, 2011 Dec;93(24):2249-54; Schairer WW et al: National utilization of reverse total shoulder arthroplasty in the United States. J Shoulder Elbow Surg, 2015 Jan;24(1):91-7; Trofa D et al: Nationwide trends in total shoulder arthroplasty and hemiarthroplasty for osteoarthritis. Am J Orthop (Belle Meade NJ), 2014 Apr;43(4):166-72; Young SW et al: Comparison of functional outcomes of reverse shoulder arthroplasty with those of hemiarthroplasty in the treatment of cuff-tear arthropathy: a matched-pair analysis. J Bone Joint Surg Am, 2013 May;95(10):910-5.

Disclosures

For this lecture, the following has been disclosed: Dr. Ekelund receives royalties and honoraria from DePuy Synthes. The planning committee reported nothing to disclose.

Acknowledgements

Dr. Ekelund was recorded at the 32nd Annual San Diego Course: Arthroscopy, Arthroplasty, and Fractures, presented by the San Diego Shoulder Institute, and held June 17-20, 2015. For information on upcoming CME programs from the San Diego Shoulder Institute, please visit sdsi-shoulder.com. The Audio Digest Foundation thanks the speakers and the San Diego Shoulder Institute for their cooperation in the production of this lecture.

CME/CE INFO

Accreditation:

The Audio- Digest Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Audio- Digest Foundation designates this enduring material for a maximum of 0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Audio Digest Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's (ANCC's) Commission on Accreditation. Audio Digest Foundation designates this activity for 0 CE contact hours.

Lecture ID:

OR382303

Expiration:

This CME course qualifies for AMA PRA Category 1 Credits™ for 3 years from the date of publication.

Instructions:

To earn CME/CE credit for this course, you must complete all the following components in the order recommended: (1) Review introductory course content, including Educational Objectives and Faculty/Planner Disclosures; (2) Listen to the audio program and review accompanying learning materials; (3) Complete posttest (only after completing Step 2) and earn a passing score of at least 80%. Taking the course Pretest and completing the Evaluation Survey are strongly recommended (but not mandatory) components of completing this CME/CE course.

Estimated time to complete this CME/CE course:

Approximately 2x the length of the recorded lecture to account for time spent studying accompanying learning materials and completing tests.