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Brennan-Olsen SL, Page RS, Lane SE, Lorimer M, Buchbinder R, Osborne RH, Pasco JA, Wluka AE, Sanders KM, Ebeling PR, Graves SE. Few geographic and socioeconomic variations exist in primary total shoulder arthroplasty: a multi-level study of Australian registry data. BMC Musculoskelet Disord 2016; 17:291. [PMID: 27421770 PMCID: PMC4947280 DOI: 10.1186/s12891-016-1134-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 06/17/2016] [Indexed: 11/17/2022] Open
Abstract
Background Associations between socioeconomic position (SEP) and the uptake of primary total shoulder arthroplasty (TSA) is not well understood in the Australian population, thus potentially limiting equitable allocation of healthcare resources. We used the Australian Orthopaedic Association National Joint Replacement Registry (AOA NJRR) to examine whether geographic or socioeconomic variations exist in TSA performed for a diagnosis of osteoarthritis 2007–11 for all Australians aged ≥40 years. Methods Primary anatomical and reverse TSA data were extracted from the AOA NJRR which captures >99 % of all TSA nationally. Residential addresses were cross-referenced to Australian Bureau of Statistics 2011 Census data to identify SEP measured at the area-level (categorised into deciles), and geographic location defined as Australian State/Territory of residence. We used a Poisson distribution for the number of TSA over the study period, and modelled the effects of age, SEP and geographic location using multilevel modelling. Results During 2007–11, we observed 6,123 TSA (62.2 % female). For both sexes, TSA showed a proportional increase with advancing age. TSA did not vary by SEP or geographic location, with the exception of greater TSA among men in New South Wales. Conclusions Using a national registry approach we provide the first reliable picture of TSA at a national level. The uptake of TSA was equitable across SEP; however, there was some variation between the States/Territories. With an aging population, it is imperative that monitoring of major surgical procedures continues, and be focused toward determining whether TSA uptake correlates with need across different social and area-based groups.
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Affiliation(s)
- Sharon L Brennan-Olsen
- School of Medicine, Deakin University, Geelong, Australia. .,Australian Institute for Musculoskeletal Sciences, The University of Melbourne, St Albans, Australia. .,Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia. .,Epi-Centre for Healthy Aging, IMPACT Strategic Research Centre, Deakin University, (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.
| | - Richard S Page
- School of Medicine, Deakin University, Geelong, Australia.,Barwon Orthopaedic Research Unit, Barwon Health, Geelong, Australia
| | - Stephen E Lane
- School of Medicine, Deakin University, Geelong, Australia.,Barwon Health Biostatistics Unit, Barwon Health, University Hospital, Geelong, Australia.,School of BioSciences, University of Melbourne, Melbourne, Australia
| | - Michelle Lorimer
- Australian Orthopaedic Association Joint Replacement Registry, Adelaide, Australia
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Centre, Melbourne, Australia.,Monash Department of Clinical Epidemiology, Cabrini Hospital, Malvern, Australia
| | - Richard H Osborne
- School of Health and Social Development, Deakin University, Melbourne, Australia.,NorthWest Academic Centre, Department of Medicine, The University of Melbourne, St Albans, Australia
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, Australia.,NorthWest Academic Centre, Department of Medicine, The University of Melbourne, St Albans, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Centre, Melbourne, Australia
| | - Kerrie M Sanders
- Australian Institute for Musculoskeletal Sciences, The University of Melbourne, St Albans, Australia.,Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia.,NorthWest Academic Centre, Department of Medicine, The University of Melbourne, St Albans, Australia
| | - Peter R Ebeling
- Australian Institute for Musculoskeletal Sciences, The University of Melbourne, St Albans, Australia.,NorthWest Academic Centre, Department of Medicine, The University of Melbourne, St Albans, Australia.,Department of Medicine, Monash University, Melbourne, Australia
| | - Stephen E Graves
- Australian Orthopaedic Association Joint Replacement Registry, Adelaide, Australia
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Van Thiel GS, Halloran JP, Twigg S, Romeo AA, Nicholson GP. The vertical humeral osteotomy for stem removal in revision shoulder arthroplasty: results and technique. J Shoulder Elbow Surg 2011; 20:1248-54. [PMID: 21420326 DOI: 10.1016/j.jse.2010.12.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 11/30/2010] [Accepted: 12/06/2010] [Indexed: 02/01/2023]
Abstract
HYPOTHESIS Revision shoulder arthroplasty represents a complex and difficult problem for the treating surgeon, with multiple potential complications. In the setting of a well-fixed humeral component, removal can lead to fractures and compromise the outcome of the revision. The current study describes and evaluates the results of a novel vertical humeral osteotomy (VHO) for stem extraction. We hypothesized that the VHO will enable successful stem extraction without perioperative or postoperative fractures. MATERIALS AND METHODS Twenty-seven patients were retrospectively identified who had a VHO for revision shoulder arthroplasty, with 23 patients available for final follow-up. Records and radiographs were reviewed for postoperative complications. Final follow-up was completed with the inclusion of shoulder scores. RESULTS There were no perioperative or postoperative fractures on clinical examination and radiographic review at an average follow-up of 41 months. Average American Shoulder and Elbow Surgeons (ASES) score was 64.7 (contralateral ASES, 76.9), average Simple Shoulder Test was 6.3, and the visual analog score pain average was 1.3. There were no instability events. DISCUSSION The glenoid is the more common site for failure in both hemiarthroplasty and total shoulder arthroplasty. This can lead to a difficult revision procedure if the ingrown or cemented humeral stem requires removal. CONCLUSION In the current study, we found the VHO was an effective tool for the removal of the humeral prosthesis with no perioperative or postoperative fractures.
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Affiliation(s)
- Geoffrey S Van Thiel
- Department of Orthopaedics, Division of Shoulder and Elbow, Rush University Medical Center, Chicago, IL, USA.
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Raiss P, Aldinger PR, Kasten P, Rickert M, Loew M. Total shoulder replacement in young and middle-aged patients with glenohumeral osteoarthritis. ACTA ACUST UNITED AC 2008; 90:764-9. [DOI: 10.1302/0301-620x.90b6.20387] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Our aim in this prospective study was to evaluate the outcome of total shoulder replacement in the treatment of young and middle-aged active patients with primary glenohumeral osteoarthritis. We reviewed 21 patients (21 shoulders) with a mean age of 55 years (37 to 60). The mean follow-up was seven years (5 to 9). The same anatomical, third-generation, cemented implant had been used in all patients. All the patients were evaluated radiologically and clinically using the Constant and Murley score. No patients required revision. In one a tear of the supraspinatus tendon occurred. Overall, 20 patients (95%) were either very satisfied (n = 18) or satisfied (n = 2) with the outcome. Significant differences (p < 0.0001) were found for all categories of the Constant and Murley score pre- and post-operatively. The mean Constant and Murley score increased from 24.1 points (10 to 45) to 64.5 points (39 to 93), and the relative score from 30.4% (11% to 50%) to 83% (54% to 116%). No clinical or radiological signs of loosening of the implant were seen. For young and middle-aged patients with osteoarthritis, third-generation total shoulder replacement is a viable method of treatment with a low rate of complications and excellent results in the mid-term.
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Affiliation(s)
- P. Raiss
- Department of Shoulder and Elbow Surgery, Orthopaedic University Hospital of Heidelberg, Schlierbacher, Landstrasse, 200a, 69118 Heidelberg, Germany
| | - P. R. Aldinger
- Department of Shoulder and Elbow Surgery, Orthopaedic University Hospital of Heidelberg, Schlierbacher, Landstrasse, 200a, 69118 Heidelberg, Germany
| | - P. Kasten
- Department of Shoulder and Elbow Surgery, Orthopaedic University Hospital of Heidelberg, Schlierbacher, Landstrasse, 200a, 69118 Heidelberg, Germany
| | - M. Rickert
- Department of Shoulder and Elbow Surgery, Orthopaedic University Hospital of Heidelberg, Schlierbacher, Landstrasse, 200a, 69118 Heidelberg, Germany
| | - M. Loew
- Department of Shoulder and Elbow Surgery, Orthopaedic University Hospital of Heidelberg, Schlierbacher, Landstrasse, 200a, 69118 Heidelberg, Germany
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Miscellaneous conditions of the shoulder: anatomical, clinical, and pictorial review emphasizing potential pitfalls in imaging diagnosis. Eur J Radiol 2008; 68:88-105. [PMID: 18406557 DOI: 10.1016/j.ejrad.2008.02.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 02/09/2008] [Accepted: 02/19/2008] [Indexed: 12/31/2022]
Abstract
The purpose of this article is to review the key imaging findings in major categories of pathology affecting the shoulder joint including hydroxyapatite deposition disease, rotator cuff interval pathology, acromioclavicular joint pathology, glenohumeral osteoarthrosis, and synovial inflammatory processes, with specific emphasis on findings that have associated pitfalls in imaging diagnosis. The pathophysiology and clinical manifestations of the above mentioned categories of pathology will be reviewed, followed in each section by a detailed pictorial review of the key imaging findings in each category including plain film, computed tomography, and magnetic resonance imaging findings as applicable. Imaging challenges that relate to both diagnosis and characterization will be addressed with each type of pathology. The goal is that after reading this article, the reader will be able to recognize the key imaging findings in major categories of pathology affecting the shoulder joint and will become familiar with the potential pitfalls in their imaging diagnosis.
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