Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD,...
-
Upload
jacob-adams -
Category
Documents
-
view
220 -
download
0
Transcript of Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD,...
![Page 1: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/1.jpg)
Trends – what do the registries tell us?
Swedish registry example
Anders NordqvistMD, PhD, Associate professor
Skane University HospitalMalmö
Sweden
![Page 2: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/2.jpg)
The swedish shoulder arthroplasty registry
• Property of the Swedish shoulder and elbow society• Started in 1999• Administrated by
Björn Salomonsson, MD, PhD,
Danderyd Hospital, Stockholm, Sweden
• Board appointed by the Swedish shoulder and elbow society:Hans Rahme, MD, PhD, Uppsala Sweden
Anders Nordqvist, MD PhD, Malmö SwedenHenrik Ahlborg, MD, PhD, Malmö, SwedenAnders Ekelund, MD, PhD, Stockholm, SwedenBjörn Salomonsson, MD, PhD, Stockholm, Sweden
![Page 3: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/3.jpg)
The swedish shoulder arthroplasty registry
• Started in 1999• Almost all Swedish hospitals participate.• Located at a major Swedish data center
in Lund, Sweden• > 90% of all swedish shoulder
arthroplasties are reported
![Page 4: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/4.jpg)
Swedish shoulder arthroplasty registry 2011
• > 8100 primary reports since 1999
• > 600 (8 %) were re-operations.
• About 1000 reports yearly – covers >90%
![Page 5: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/5.jpg)
News 2011
• Webbased report function.
• SITHS card authorisation of user.
• New database at RCSyd.
• New possibilities for analyse.
![Page 6: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/6.jpg)
The swedish shoulder arthroplasty registry
Primary report:• Primary and revision arthroplasties• Diagnosis• Arthroplasty concept• Name of prosthesis • Surgical method• Complications• WOOS score – some shoulder units
![Page 7: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/7.jpg)
The swedish shoulder arthroplasty registry
• Revision surgery reported• 1 year, 5 years and 10 years follow-up
with self-evaluated score• WOOS score• EQ-5D
![Page 8: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/8.jpg)
Registered Swedish shoulder arthroplasties 1999 – 2011
Annual reports
![Page 9: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/9.jpg)
Hemi-arthroplasty
• Degenerative or post traumatic conditions
• Displaced 3-4 part fractures of the proximal humerus
![Page 10: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/10.jpg)
Hemi-arthroplasties (HHR)Annual reports
![Page 11: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/11.jpg)
Hemi-arthroplasty
• Traditional hemi-arthroplasty with stemmed prosthesis
last years also short stem prosthesis
• Bi-polar arthroplasty
• Resurfacing prosthesis
![Page 12: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/12.jpg)
Hemi-arthroplasties 1999 – 2011(Fracture prosthesis excluded)
![Page 13: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/13.jpg)
Anatomical total shoulder arthroplasty
Traditional total shoulder arthroplasty as originally described by Neer
Requires a stable shoulder with well functioning rotator cuff
More technically demanding for the surgeon than hemiarthroplasty
![Page 14: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/14.jpg)
Anatomical total shoulder arthroplasty (TSR)1999 – 2011
Annual reports
![Page 15: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/15.jpg)
Results 2009
• Of the 2666 primary reports during 1999-2004 – 57% answered. – 20% was dead (or lost address).– 23% did not answer.
• The 5 year WOOS was analysed.
![Page 16: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/16.jpg)
Results WOOS 5 year
Rheumatoid arthritis
– HSA (n = 187) had WOOS 61% – TSA (n = 37) had WOOS 70%
• Bipolar HSA (n = 15) had 57%.• p<0,05 between TSA and HSA
Osteoarthrosis
– HSA (n = 180) had WOOS 68% – TSA (n = 92) had WOOS 83%,
• Resurfacing HSA (n = 18) WOOS 67%– p<0,001 between TSA and HSA
![Page 17: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/17.jpg)
Revisions 2009
Among 637 reported re-operations, we had the index-operation in the register for 218 shoulders. Of these– 62 shoulders OA– 41 shoulders RA
![Page 18: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/18.jpg)
Revisions until 2009
Osteoarthritis 1999-2009 (n=2625)– HSA: 37 revisions for Glenoid / 1311 (2,8%)– TSA: 3 revisions for Glenoid / 852
(0,4%)
Rheumatoid arthritis 1999-2009 (n=1070)– HSA: 16 revisions for Glenoid / 634 (2,5%)– TSA: 2 revisions for Glenoid / 192
(1%)• Bipolar: 3 revisions for Glenoid / 39 (8%)
![Page 19: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/19.jpg)
Reverse total shoulder arthroplasty
• Delta reverse shoulder arhroplasty described by Grammont 1993
• Anders Ekelund in Stockholm started to evaluate the prosthesis in Sweden
• During the last 5 – 10 years more frequent used at the major shoulder centers in Sweden
• More complex cases
![Page 20: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/20.jpg)
Reverse shoulder arthroplasties in Sweden 1999 – 2011
Annual reports
![Page 21: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/21.jpg)
Reverse total shoulder arthroplasty in Sweden 1999 - 2011
• 1999 – 2007 almost all reverse shoulder arthoplasties were Delta 3
• Since 2007 most reverse shoulder arthroplasties were Delta Xtend but during the last years other prosthesis also have been reported
![Page 22: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/22.jpg)
Reverse total shoulder arthroplasty in Sweden 1999 – 2011
Indications
• Rotator cuff arthropathy• Osteoarthrosis• Rheumatoid arthritis• Acute fracture• Sequele after fracture• Revision arthroplasty
![Page 23: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/23.jpg)
Reverse shoulder arthroplasties in Sweden 1999 - 2011
Annual reports
![Page 24: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/24.jpg)
Revision surgery 1999 – 2011Annual reports
![Page 25: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/25.jpg)
Summary: Trends 1999 – 2011
Hemiarthroplasty (HHR), anatomical total shoulder arthroplasty (TSR) and reverse shoulder arthroplasty
![Page 26: Trends – what do the registries tell us? Swedish registry example Anders Nordqvist MD, PhD, Associate professor Skane University Hospital Malmö Sweden.](https://reader030.fdocuments.us/reader030/viewer/2022033102/56649de75503460f94ae11ef/html5/thumbnails/26.jpg)
Shoulder arthroplasty trends – what do the registries tell us?
Swedish registry exampleConclusions:
• There is a marked increase of shoulder arthroplasties in Sweden from 1999 – 2011
• Hemiarthroplasties show a modest increase. Resurfacing arthroplasties have decreased and short stem arthroplasties have increased instead.
• There is a significant increase of both anatomical and reverse total shoulder arthroplasties.
• Cuffarthropathy, revision cases, fracture sequele aswell as acute fractures are treated with reverse shoulder arthroplasty