The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR)
Background and purpose — The increase in shoulder arthroplasty may lead to a burden of revision surgery. This study compared the rate of (2nd) revision following aseptic 1st revision shoulder arthroplasty, considering the type of primary, and the class and type of the revision. Patients and methods...
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2021-05-01
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Online Access: | http://dx.doi.org/10.1080/17453674.2020.1871559 |
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doaj-6a59c0d9c269450fa73c4f157d44e5ab2021-07-06T12:16:07ZengTaylor & Francis GroupActa Orthopaedica1745-36741745-36822021-05-0192325826310.1080/17453674.2020.18715591871559The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR)David R J Gill0Richard S Page1Stephen E Graves2Sophia Rainbird3Alesha Hatton4Orthopaedics CentralBarwon Centre of Orthopaedic Research and Education, Deakin UniversityAustralian Orthopaedic Association National Joint Replacement Registry (AOANJRR)Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR)South Australia Health and Medical Research Institute (SAHMRI)Background and purpose — The increase in shoulder arthroplasty may lead to a burden of revision surgery. This study compared the rate of (2nd) revision following aseptic 1st revision shoulder arthroplasty, considering the type of primary, and the class and type of the revision. Patients and methods — All aseptic 1st revisions of primary total reverse shoulder arthroplasty (rTSA group) and of primary total stemmed and stemless total shoulder arthroplasty (non-rTSA group) procedures reported to our national registry between April 2004 to December 2018 were included. The rate of 2nd revision was determined using Kaplan–Meier estimates and comparisons were made using Cox proportional hazards models. Results — There was an increased risk of 2nd revision in the 1st month only for the rTSA group (n = 700) compared with the non-rTSA group (n = 991); hazard ratio (HR) = 4.8 (95% CI 2.2–9). The cumulative percentage of 2nd revisions (CPR) was 24% in the rTSA group and 20% in the non-rTSA group at 8 years. There was an increased risk of 2nd revision for the type (cup vs. head) HR = 2.2 (CI 1.2–4.2), but not class of revision for the rTSA group. Minor (> 3 months) vs. major class revision, and humeral revision vs. all other revision types were second revision risk factors for the non-rTSA group. Interpretation — The CPR of revision shoulder arthroplasty was > 20% at 8 years and was influenced by the type of primary, the class, and the type of revision. The most common reasons for 2nd revision were instability/dislocation, loosening, and infection.http://dx.doi.org/10.1080/17453674.2020.1871559 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David R J Gill Richard S Page Stephen E Graves Sophia Rainbird Alesha Hatton |
spellingShingle |
David R J Gill Richard S Page Stephen E Graves Sophia Rainbird Alesha Hatton The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) Acta Orthopaedica |
author_facet |
David R J Gill Richard S Page Stephen E Graves Sophia Rainbird Alesha Hatton |
author_sort |
David R J Gill |
title |
The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) |
title_short |
The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) |
title_full |
The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) |
title_fullStr |
The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) |
title_full_unstemmed |
The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) |
title_sort |
rate of 2nd revision for shoulder arthroplasty as analyzed by the australian orthopaedic association national joint replacement registry (aoanjrr) |
publisher |
Taylor & Francis Group |
series |
Acta Orthopaedica |
issn |
1745-3674 1745-3682 |
publishDate |
2021-05-01 |
description |
Background and purpose — The increase in shoulder arthroplasty may lead to a burden of revision surgery. This study compared the rate of (2nd) revision following aseptic 1st revision shoulder arthroplasty, considering the type of primary, and the class and type of the revision. Patients and methods — All aseptic 1st revisions of primary total reverse shoulder arthroplasty (rTSA group) and of primary total stemmed and stemless total shoulder arthroplasty (non-rTSA group) procedures reported to our national registry between April 2004 to December 2018 were included. The rate of 2nd revision was determined using Kaplan–Meier estimates and comparisons were made using Cox proportional hazards models. Results — There was an increased risk of 2nd revision in the 1st month only for the rTSA group (n = 700) compared with the non-rTSA group (n = 991); hazard ratio (HR) = 4.8 (95% CI 2.2–9). The cumulative percentage of 2nd revisions (CPR) was 24% in the rTSA group and 20% in the non-rTSA group at 8 years. There was an increased risk of 2nd revision for the type (cup vs. head) HR = 2.2 (CI 1.2–4.2), but not class of revision for the rTSA group. Minor (> 3 months) vs. major class revision, and humeral revision vs. all other revision types were second revision risk factors for the non-rTSA group. Interpretation — The CPR of revision shoulder arthroplasty was > 20% at 8 years and was influenced by the type of primary, the class, and the type of revision. The most common reasons for 2nd revision were instability/dislocation, loosening, and infection. |
url |
http://dx.doi.org/10.1080/17453674.2020.1871559 |
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