The utility of international shoulder joint replacement registries and databases: a comparative analytic review of two hundred and sixty one thousand, four hundred and eighty four cases
These authors indicate that national databases provide an unselected view of shoulder joint replacement within geographical areas that cannot be obtained from case series or prospective studies. They can be particularly helpful in determining which diagnoses, patients, procedures, and prostheses have higher than expected rates of revision.
In an attempt to determine the generalizability of registry data, they analyzed seven national shoulder arthroplasty registries and five publications regarding national shoulder arthroplasty data containing a combined total of 261,484 shoulder arthroplasty cases.
These authors indicate that national databases provide an unselected view of shoulder joint replacement within geographical areas that cannot be obtained from case series or prospective studies. They can be particularly helpful in determining which diagnoses, patients, procedures, and prostheses have higher than expected rates of revision.
In an attempt to determine the generalizability of registry data, they analyzed seven national shoulder arthroplasty registries and five publications regarding national shoulder arthroplasty data containing a combined total of 261,484 shoulder arthroplasty cases.
They found that percentages of hemiarthroplasty, anatomic and reverse total shoulders, the diagnoses leading to arthroplasty, the mean patient age, and the distribution of patient gender varied significantly with geographical location. They suggest that these variations must be considered when comparing outcomes of shoulder arthroplasty from different locations.
In the charts below it can be see that the prevalence of rheumatoid arthritis among patients receiving shoulder arthroplasty varied from 0.9% in the US to 41% in Scotland.
In the charts below it can be see that the prevalence of rheumatoid arthritis among patients receiving shoulder arthroplasty varied from 0.9% in the US to 41% in Scotland.
and that the percentage of reverse shoulder arthroplasty varied from 0% in Scotland to 63% in Italy and the Netherlands.
They point out that these national data provide the opportunity to reduce costs by identifying implants and procedures with higher failure rates. Below are examples from the Australian registry.
The establishment and maintenance of a registry that captures an unbiased and complete inclusion of shoulder arthroplasties in a defined patient population is both difficult and expensive. In order to preserve the integrity of these registries, their funding needs to be stable and free of conflicts of interest. Conflict-free funding has been achieved in several instances from either national departments of health or from large health plans.
The authors conclude that while hundreds of thousands of shoulder arthroplasties are performed each year around the world, reliable data are available on very few of them. Most of the publications on shoulder arthroplasty.
A related article was recently published: International variation in shoulder arthroplasty
These authors assessed international trends in use of shoulder arthroplasty, and described the current state of procedure selection and outcome presentation as documented in nine national and regional joint registries (Norway, Sweden, New Zealand, Denmark, California, Australia, Emilia-Romagna, Germany, and United Kingdom).
A related article was recently published: International variation in shoulder arthroplasty
These authors assessed international trends in use of shoulder arthroplasty, and described the current state of procedure selection and outcome presentation as documented in nine national and regional joint registries (Norway, Sweden, New Zealand, Denmark, California, Australia, Emilia-Romagna, Germany, and United Kingdom).
They found that shoulder arthroplasty incidence rate in 2012 was 20 procedures/100,000 population with a 6-fold variation between the highest (Germany) and lowest (United Kingdom) country. The annual incidence rate increased 2.8-fold in the past decade.
Within the indications osteoarthritis, fracture, and cuff-tear arthropathy variations in procedure choice between registries were large.
These findings point to the wide variation in use of and indications for shoulder arthroplasty. Analysis is complicated by inconsistency in the definitions of diagnoses, procedures, and outcomes.
Nevertheless, registries that are durably funded with encompassing unbiased patient inclusion can provide data that is otherwise unavailable.
A very real opportunity exists for surgeons from different nations to collaborate on the design, implementation, and support of standardized joint registries.
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