Epidemiology and Demographics of Reverse Shoulder Arthroplasty

Abstract

The number of shoulder arthroplasties implanted has increased rapidly during the past 15 years. Recently accumulative data from different national shoulder arthroplasty registers in Europe, the USA, Australia, and New Zealand recorded a decrease or stable number of shoulder hemiarthroplasty (HA) procedure and an increase of total shoulder arthroplasty (TSA) implants. Recently, reverse TSA (rTSA) was coded separately from anatomic TSA (aTSA) in many different national arthroplasty registers, giving the opportunity to have more precise outlook on its effective use, disease indications, and patient demographics.

Substantial differences in indications for rTSA implant exist among different countries. In regions and countries like Emilia-Romagna, Australia, the UK, and the USA, rTSA is the most frequently implanted shoulder prosthesis, while HA is more frequently implanted in Sweden and aTSA in Germany. Since the national registry introduction, for rTSA in Norway and New Zealand, a substantial increase from 12% to 52% and 2% to 56%, respectively, was observed, while in Sweden its use remained stable on 6–10%. Moreover, in the rTSA group, a considerable discrepancy between registers can be observed according to different disease indications. Anyway, cuff tear arthropathy and proximal humerus fracture resulted to be the main indications for rTSA in most registers. The vast majority of patients are females and patients aged over 70 years old. The advancing of shoulder arthroplasty registers all over the countries and a standardization of data gathering would enable a better overview on the current situation and clarify indications on implant selection per pathology.