Anatomical total shoulder arthroplasty used for glenohumeral osteoarthritis has higher survival rates than hemiarthroplasty: A Nordic registry-based study

OBJECTIVE: To report the10-year survival rates of different shoulder arthroplasty types used for glenohumeral osteoarthritis.

DESIGN: Data from 2004-2013 was prospectively collected by the national shoulder arthroplasty registers in Denmark, Norway and Sweden and merged into a harmonized dataset under the umbrella of the Nordic Arthroplasty Register Association. The common dataset included data that all three registers could deliver and where consensus regarding definitions could be made. Revision was defined as removal or exchange of any component or the addition of a glenoid component.

RESULTS: The cumulative survival rates at 10 years after resurfacing hemiarthroplasty (n=1,923), stemmed hemiarthroplasty (n=1,587) and anatomical total shoulder arthroplasty (n=2,340) were 0.85, 0.93 and 0.96 respectively (p<0.001, Log rank test). Resurfacing hemiarthroplasty (HR: 2.5; CI 1.9-3.4, p<0.001) and stemmed hemiarthroplasty (HR: 1.4; CI 1.0-2.0, p<0.04) had an increased risk of revision compared to total shoulder arthroplasty. Gender, age and period of surgery were included in the Cox regression model. For patients below 55 years, the 10-year cumulative survival rates were 0.75 (resurfacing hemiarthroplasty, n=354), 0.81 (stemmed hemiarthroplasty, n=146), and 0.87 (total shoulder arthroplasty, n=201).

CONCLUSIONS: Anatomical total shoulder arthroplasty had the highest implant-survival rate. Young patients had, independently of the arthroplasty type, lower implant-survival rates. The treatment of young patients with end-stage osteoarthritis remains a challenge.

CONCLUSIONS: Anatomical total shoulder arthroplasty had the highest implant-survival rate. Young patients had, independently of the arthroplasty type, lower implant-survival rates. The treatment of young patients with end-stage osteoarthritis remains a challenge.