These authors investigated the prevalence of shoulder arthroplasty (the number of individuals with a shoulder arthroplasty alive at a certain time) and its implications for the burden of revision procedures using the National Inpatient Sample (NIS) for all patients who underwent total shoulder arthroplasty (TSA), including both anatomic and reverse TSA, and hemiarthroplasty between 1988 and 2017.
In 2017, an estimated 823,361 patients were living in the United States with a shoulder replacement. This represents a prevalence of 0.258%, increasing markedly from 1995 (0.031%) and 2005 (0.083%).
Female patients had a higher prevalence at 0.294% than male patients at 0.221%.
The prevalence of shoulder arthroplasty was over 50% higher in the midwest than in the northeast.
Over 2% of people who were 80 years of age in the United States were living with a shoulder replacement. Approximately 60% of patients living with a shoulder replacement had undergone the operation recently (within the last 4 years).
The incidence of revision shoulder arthroplasty is increasing on an essentially linear annual basis, with 10,290 revision procedures performed in 2017, costing the U.S. health-care system $205 million.
Comment: The prevalence of shoulder arthroplasty can be expected to increase rapidly recognizing that most of the individuals living with shoulder arthroplasty had their procedure within the last four years. As a result the number and cost of revision arthroplasty can be expected to continue to grow as well.
The geographical difference prevalence shown in the map above is not explained in the manuscript. We note that the shoulder arthroplasty procedural volume data were obtained from the National Inpatient Sample and the population data were from the U.S. Census Bureau. Thus one cannot be confident that the procedures performed in one geographical area were performed on individuals that live in that area.
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