Latest Results from the
Swedish Shoulder
Arthroplasty Register
2012:
Björn Salomonsson
The Swedish Shoulder
Arthroplasty Register:
Started 1999
News
 New database at RCSyd.
 New possibilities for analyse.
2012
 > 8700 primary reports since 1999
 > 741 (8 %) were re-operations.
 About 1200 reports yearly
 covers >90%
2012
 WOOS score, Satisfaction and EQ5D since
2004:




> 980 Pre-operative
> 600 answers, 1-year.
> 2250 answers, 5-year
> 260 answers, 10 year.
 But not all are complete.
Results 2012
 Of the 2666 primary reports 1999-2004
in the register 1530 answered at 5 year.
 57% answered.
 20% was dead (or lost address).
 23% did not answer.
Demografics
Arthritis
N
Percent
Other
17
1.7
Psoriasis
19
1.9
Juvenil RA
31
3.1
RA
927
93.3
Total
994
100
Demografics
OA
Other
N
Percent
13
0.6
360
16.5
Prima ry
1815
83.0
Total
2188
100
Secundary
Demografics
Fracture
Healed
N
Percent
33
1.2
Malunion
203
7.6
Pseudartros is
237
8.9
Fresh > 2 v.
304
11.4
Fresh < 2 v.
1892
70.9
Total
2669
100
Results 2012
 The 1, 5 and 10 year WOOS from
primary procedures was analysed.
Results WOOS 1 year
 RA
 HSA had
WOOS 68%
 Resurfacing WOOS 68%
 TSA had
 Reversed
WOOS 80%
WOOS 77%
 OA
 HSA
WOOS 75%
 Resurfacing WOOS 76%
 TSA
WOOS 86%
 p<0,001 between TSA and HSA OA
 Reversed
WOOS 77%
Osteoartrosis, WOOS
Pre
OA Hemi
OA Total
1 Œr
5 Œr
10 Œr
N
134
75
283
44
MIN
5.2
14.2
4.6
16.3
MAX
89.5
99.8
99.9
98.1
MEAN
33.78
75.37
69.78
72.50
N
303
181
185
15
MIN
2.9
26.6
21.9
37.4
MAX
93.8
99.9
100
99.9
MEAN
39.51
86.20
84.87
79.56
RA, WOOS
Pre
RA Hemi
RA Total
1 Œr
5 Œr
10 Œr
N
39
31
264
50
MIN
9.3
7.2
2.9
3
MAX
91.4
99.1
100
96.2
MEAN
38.61
68.17
63.23
67.35
N
30
17
53
6
MIN
12.1
29.5
22.5
64.7
MAX
69
98.8
99.9
95.3
MEAN
37.9
79.94
69.85
82.3
Results WOOS 5 year
 RA
 HSA
 TSA
WOOS 63%
WOOS 70%
 p<0,05 between TSA and HSA
 OA
 HSA
 TSA
WOOS 70%
WOOS 85%
 p<0,001 between TSA and HSA
WOOS over time
WOOS% pre-op and F .U. Rev erse excluded.
100
90
86
80
85
80
75
70
68
6
64
3
60
50
40
70
82
80
72
67
O A H emi
O A T otal
RA H emi
RA T otal
Fx H emi
50
3
39
8
34
30
20
10
0
P re
1Y
5Y
10Y
EQ5D over time
EQ5D 2012 Pre, 1, 5, 10 y ears, Rev erse excluded
0 ,8
0 ,7
0 ,6 9 1
0 ,6
0 ,5 6 3
0 ,5 0 9
0 ,4 9 1
0 ,5
0 ,5 8 5
0 ,5 1 3
0
0 ,4
,4 7
62
4
0 ,4 3 3
0 ,4
0 ,3
0 ,3 9 9
0 ,3 9 8
0 ,5 9 2
0 ,3 9 3
0
0 ,4
,4 6
55
5
0 ,4 1 5
0 ,3 4 4
2
0 ,3 2 4
0 ,2
0 ,1
0
P re
1Y
5Y
10Y
O A H emi
O A T otal
RA H emi
RA T otal
Fx H emi
EQ5D, Bimodal?
Results RA / Osteoartrosis:
 Survival 10 year Kaplan-Mayer: RA 4,8% OA 3,3%
 Cumulative Revision Rate after indexoperation 1999-2009
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
Revisions until 2009
 OA 1999-2009 (n=2625)
 HSA: 37 revisions for Glenoid / 1311
 TSA: 3 revisions for Glenoid / 852
(2,8%)
(0,4%)
 RA 1999-2009 (n=1070)
 HSA: 16 revisions for Glenoid / 634
 TSA: 2 revisions for Glenoid / 192
 Bipolar: 3 revisions for Glenoid / 39
(8%)
(2,5%)
(1%)
Results HSA / TSA:
 Survival 10 year Kaplan-Mayer, HSA 3,4% TSA 2,4%
 Cumulative Revision Rate after indexoperation 1999-2009
Results HSA / TSA:
 Survival 10 year
 Risk Ratio versus Hemi after indexoperation 1999-2009
Primary
Re-op
3756
126
51
4
0.61
1.30
0.48-3.55
Resurf vs Hemi
445
13
0.85
0.94
0.52-1.71
Reverse vs Hemi
438
26
0.00
3.81
2.44-5.95
Total vs Hemi
799
19
0.23
0.74
0.46-1.21
Gender F vs M
0.06
0.75
0.56-1.01
Age
0.00
0.96
0.95-0.97
Year surgery
0.34
0.97
0.91-1.03
Hemi
Bipola r vs Hemi
P
Risk
ratio
95% C I
ref.
Results Fx 5 year 2009
 Fractures
 HSA
WOOS 65%
 < 2 weeks to surgery
 > 2 weeks to surgery
WOOS 68%
WOOS 61%
 Malunion
 Non union
WOOS 56%
WOOS 43%
Fracture, WOOS
Pre
Fracture Hemi
1 Œr
5 Œr
10 Œr
N
14
8
525
49
MIN
10.1
17.1
3.8
15
MAX
100
80.3
100
99.6
MEAN
56.52
50.04
64.51
67.16
Results Fx < 2w / >2w:
 Survival 10 year Kaplan-Mayer 1,8% / 1,5%
 Cumulative Revision Rate after indexoperation 1999-2009
Revisions until 2009
 Fracture 1999-2009 (n=2421)
 Instability (n=15)
 Infection (n=10)
 Glenoid (HSA) (n=6)
0,06%
0,04%
0,02%
 Nonunion 1999-2009 (n=262)
 Instability (n=6)
 Infection (n=5)
2,3%
2%
 Cuffarthropathy 1999-2009 (n=264)
 Instability (n=9)
 Infection (n=8)
3,4%
3%
Scandinavian Shoulder
Meeting 2013 Sweden
 MALMÖ 2013 April 25-26
BOA Registry, Start 2008
Artrosis Start 2008
Education by physiotherapist
Meeting “expert” patient, how to manage
Training, individuel or group
BOA Registry
BOA Registry
Fracture Registry





Start 2012
All fractures at hospitals
Classification by “AO”
Treatment
1 year PROM
Fracture Registry
Fracture Registry
Fracture Registry
Fracture Registry
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