Abstract
Introduction As a consequence of the Swedish model, endoprosthesis
registers have become increasingly important worldwide. Due to the
increasing number of joint replacements at the shoulder, these are being
increasingly included in the register databases – in addition to
interventions at the hip and knee joint. In this study, the value of
endoprosthesis registers is investigated, using the example of shoulder
endoprosthetics and including a comparison with clinical studies.
Material and Methods The annual reports of 32 different endoprosthesis
registers with data on hip, knee and/or shoulder arthroplasty were analysed.
The number of operations and demographic patient data for all areas of
endoprosthetics were examined. In addition, a more detailed consideration of
variables such as the primary diagnosis, the cause of the revision, the
revision rate depending on risk factors and patient-reported outcome
measures (PROM scores) was carried out exclusively for the shoulder joint
endoprostheses. Using the example of the inverse shoulder prosthesis,
clinical studies were compared to registry data with special regard to the
revision rate.
Results A total of 20 endoprosthesis registers could be included, 9 of
these collected data on shoulder arthroplasty. The main primary diagnoses
were osteoarthritis (40.6%), rotator cuff defect arthropathy (30.2%) and
fractures (17.6%). The most commonly used shoulder joint endoprosthesis was
the inverse prosthesis (47.3%). The proportion of revision surgeries in
total shoulder arthroplasty operations was less than 10% in all registers.
In addition to the revision rate, the PROM scores were sometimes used in the
registers to evaluate the success of the prosthesis. Compared to registry
data, clinical studies showed more heterogeneous data with a significantly
higher revision rate of over 10% in long-term follow-up – using the example
of the inverse shoulder prosthesis.
Conclusion Register data are a valuable source of information in
shoulder arthroplasty and can make a significant contribution to the quality
assurance of endoprosthetic treatments. Compared to clinical studies, they
primarily provide data on durability of different endoprosthesis and give
lower revision rates. Clinical studies use PROM scores and clinical and
radiological examinations to focus only on individual implants and surgical
centres on the one hand and much more on the functional results on the
other.
Keywords
endoprosthesis register - shoulder arthroplasty - endoprosthesis revision surgery
