The Swedish Shoulder Arthroplasty Register.
An analysis of 255 re-operations on arthroplasties reported to the register.
Ulf Lillkrona MD PhD Anders Nordqvist MD PhD Hans Rahme MD PhD Björn Salomonsson MD The Swedish Shoulder and Elbow Society Board of Quality Registers
1999-2006
Experiences of 8 years
THE REGISTER
• Started 1999 • All Swedish hospitals except 2 participates. • Is owned by the Swedish Shoulder and Elbow Society. • Covers more than 90% in Sweden.
REPORTS 1999 -2006
Total 4238 reports (285 / 3953)
Re-operation 7%
Primary arthroplasty 93%
MOST COMMON DIAGNOSES
The most common diagnoses
1600
1432
1400
1215
1200
1000 731 800
600
400
200
0 Reumatoid OsteoArthritis Fracture
RE-OPERATIONS
Revison/Reoperation 285 st (243 / 42)
Other re-op 15%
Revision 85%
133 WITH INDEX 1999-2006
133 reop since 1999 (118 / 15)
No report 11%
Index report 89%
REASON FOR RE-OPERATION
Reason for Re-operation
3,9% 2,1% 16,5%
Glenoid erosion Pain Loose glenoid Loose stem Infection Periprostetic fx 20,7% Instability Loose tubercle 6,3% Cuff insuff
2,1% 1,8% 6,7% 4,2%
RE-OPERATION
Re-operation procedure
1,4% 2,1%
1,4%
4,9% 17,5%
Change Stem Change mod-Caput Change Glenoid Glenoid insert Delta plastic change Spacer Lavage Extraktion Implant
2,5%
1,1% 1,4% 0,7%
Other soft tissue Arthroscopy Refix Tubercles Closed reduction
7,4% 0,7%
6,0%
RE-OPERATION / DIAGNOSE
Re-operation burden / Diagnose
7,0% 6,5%
6,0%
5,0%
4,8% 4,4%
4,0% 3,4% 3,1% 3,0%
2,1% 2,0%
2,0% 1,5%
1,0%
0,0% Cuff Arthropathy Nonunion Ostenecrosis Reumatoid Osteoartrosis Fracture Malunion Other
DIAGNOSE / MEAN TIME TO RE-OPERATION
Diagnose / Time to re-op (years)
5 4,7 4,5
4
3,5
3 2,6 2,5 2,4
2
1,8
1,8
1,5 1,2 1 1,2
0,5
0 Cuff Arthropathy Fracture Malunion Nonunion Ostenecrosis Osteoartrosis Reumatoid
100
200
300
400
500
600
700
800
0
B ip ol ar
49 7
D el ta -3
210 17
N ee r 2
395 15
N ee r 3
108 3
G lo ba l
255 14
3 M -M od ul ar
21 594
B ig l ia ni -F la to w
18
694
N ot ti n gh am
12
534
G lo ba l A dv
80 3
G lo ba l Fx
8
To rn ie r A eq u al is
11
Implants: Prim op / Re-operation
232 319
IMPLANTS
A n at om ic al /S G u lo lz ba r Fx ie
To rn
89
1
er
1
71
l C
C op
ap
1
44
el
an
d
1
166 Re-op Prim-op
10,0%
12,0%
14,0%
16,0%
0,0%
2,0%
4,0%
6,0%
8,0%
B ip ol ar
14,3%
D el ta -3
8,1%
N ee r 2
3,8%
N ee r 3
2,8%
G lo ba l
5,5%
3 M -M od ul ar
3,5%
B ig l ia ni -F la to w
2,6%
N ot ti n gh am
2,2%
G lo ba l A dv
Implants / Re-operation burden
3,8%
G lo ba l Fx To rn ie r A eq u al is
IMPLANTS
3,4% 3,4%
To A n at om
rn ic
ie al
r /S
Fx u G
1,1%
lz lo
er ba
1,4%
l C
C
ap op el
2,3%
an
d
0,6%
CONCEPT / REVISION BURDEN
Revision
6,0%
5,7%
5,0%
4,1% 4,0%
3,0% 2,6% 2,2% 2,0%
Hemi Total
1,0%
0,0% Index op All reports
CONCEPT / REVISION BURDEN
Concept / Revision burden
12,0%
10,2% 10,0%
8,0%
6,0% 4,8%
4,0%
2,5% 2,0% 1,1%
0,0% Bipolar (n=49) Delta-3 (n=210) Hemi (n= 3147) Total (n=476)
CONCEPT/GLENIOD PROBLEM
Glenoid Erosion / Loosening-Wear
2,5%
2,4%
2,0% 2,0% 1,7%
1,5%
1,0% 0,8%
0,5%
0,0% Bipolar Delta-3 Hemi Total
CONCLUSION
• The Swedish Shoulder Arthroplasty Register now has a possibility to analyse revision rate and reason to re-operations for different implants as well as diagnoses.
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