TY - JOUR

T1 - The short-term survival of total stemless shoulder arthroplasty for osteoarthritis is comparable to that of total stemmed shoulder arthroplasty

T2 - a Nordic Arthroplasty Register Association study

AU - Rasmussen, Jeppe V.

AU - Harjula, Jenni

AU - Arverud, Erica D.

AU - Hole, Randi

AU - Jensen, Steen L.

AU - Brorson, Stig

AU - Fenstad, Anne Marie

AU - Salomonsson, Björn

AU - Äärimaa, Ville

PY - 2019

Y1 - 2019

N2 - Background: The purpose of this study was to compare the short-term survival rate of total stemless, metaphyseal fixated, shoulder arthroplasty with that of total stemmed shoulder arthroplasty in the treatment of osteoarthritis. Methods: Data were collected by the national arthroplasty registries in Denmark, Finland, Norway, and Sweden and merged into 1 dataset under the umbrella of the Nordic Arthroplasty Register Association. For the present study, we included all patients with osteoarthritis treated with either stemless (n = 761) or stemmed (n = 4398) shoulder arthroplasty from 2011 to 2016. Results: A total of 21 (2.8%) stemless and 116 (2.6%) stemmed shoulder arthroplasties were revised. The 6-year unadjusted cumulative survival rates were 0.953 for stemless shoulder arthroplasty and 0.958 for stemmed shoulder arthroplasty, P = .77. The most common indication for revision of both arthroplasty types was infection. Five (0.7%) stemless and 16 (0.4%) stemmed shoulder arthroplasties were revised because of loosening of either the glenoid or the humeral component. In the multivariate cox regression model, which included age, category, gender, year of surgery, previous surgery, and arthroplasty type, the hazard ratio (HR) for revision of the stemless shoulder arthroplasty was 1.00 (95% confidence interval [CI], 0.63-1.61), P = .99, with the stemmed shoulder arthroplasty as reference. Male gender (HR = 1.50 [95% CI, 1.06-2.13], P = .02) and previous surgery (HR = 2.70 [95% CI, 1.82-4.01], P < .001) were associated with increased risk of revision. Conclusion: The short-term survival of total stemless shoulder arthroplasty appears comparable with total stemmed shoulder arthroplasty, but longer observation time is needed to confirm whether they continue to perform equally.

AB - Background: The purpose of this study was to compare the short-term survival rate of total stemless, metaphyseal fixated, shoulder arthroplasty with that of total stemmed shoulder arthroplasty in the treatment of osteoarthritis. Methods: Data were collected by the national arthroplasty registries in Denmark, Finland, Norway, and Sweden and merged into 1 dataset under the umbrella of the Nordic Arthroplasty Register Association. For the present study, we included all patients with osteoarthritis treated with either stemless (n = 761) or stemmed (n = 4398) shoulder arthroplasty from 2011 to 2016. Results: A total of 21 (2.8%) stemless and 116 (2.6%) stemmed shoulder arthroplasties were revised. The 6-year unadjusted cumulative survival rates were 0.953 for stemless shoulder arthroplasty and 0.958 for stemmed shoulder arthroplasty, P = .77. The most common indication for revision of both arthroplasty types was infection. Five (0.7%) stemless and 16 (0.4%) stemmed shoulder arthroplasties were revised because of loosening of either the glenoid or the humeral component. In the multivariate cox regression model, which included age, category, gender, year of surgery, previous surgery, and arthroplasty type, the hazard ratio (HR) for revision of the stemless shoulder arthroplasty was 1.00 (95% confidence interval [CI], 0.63-1.61), P = .99, with the stemmed shoulder arthroplasty as reference. Male gender (HR = 1.50 [95% CI, 1.06-2.13], P = .02) and previous surgery (HR = 2.70 [95% CI, 1.82-4.01], P < .001) were associated with increased risk of revision. Conclusion: The short-term survival of total stemless shoulder arthroplasty appears comparable with total stemmed shoulder arthroplasty, but longer observation time is needed to confirm whether they continue to perform equally.

KW - arthroplasty

KW - collaboration

KW - Large Database Analysis

KW - Level III

KW - registry

KW - Retrospective Design

KW - revision

KW - shoulder

KW - Stemless

KW - stemmed

KW - survival

KW - Treatment Study

U2 - 10.1016/j.jse.2019.01.010

DO - 10.1016/j.jse.2019.01.010

M3 - Journal article

C2 - 31043348

AN - SCOPUS:85064597771

VL - 28

SP - 1578

EP - 1586

JO - Journal of Shoulder and Elbow Surgery

JF - Journal of Shoulder and Elbow Surgery

SN - 1058-2746

IS - 8

ER -