Clin Should Elbow.  2024 Sep;27(3):286-294. 10.5397/cise.2023.01137.

Experiences and outcomes in shoulder replacements in a district general hospital over 19 years

• Dekker AP
• Hind J
• Ashwood N

• KMID: 2563623
• DOI: http://doi.org/10.5397/cise.2023.01137

Abstract

Background
This study aimed to evaluate the changing experiences of shoulder surgeons working in a district general hospital.
Methods
A consecutive series of 395 shoulders (225 male, 170 female) over a 19-year period (2000–2019) with a minimum follow-up of 2 years were analyzed. Outcome measures were length of stay, operating time, satisfaction visual analog score (VAS), pain VAS, Oxford Shoulder Score (OSS), Constant-Murley score, range of movement, complications, and implant survival.
Results
The incidence of a diagnosis of osteoarthritis as the surgical indication increased over time. The number of cases by surgeon per year increased from three cases in 2,000 to a peak of 33 in 2011. Up to seven implant manufacturers were used. The incidence of hemiarthroplasties decreased, and more numerous reverse polarity and anatomic arthroplasties were performed (P<0.001). More glenoid and humeral components were cemented and more short-stem implants were used in later years (P<0.001). Length of stay was a median of 1 day with a trend towards daytime surgery in recent years. Patients were satisfied (VAS 8/10) and OSS improved by 8 points on average throughout the observation period.
Conclusions
Despite frequent introductions of new implants, patient outcome, satisfaction, and complication rates remained good. There appears to be a need for large-scale, generalizable studies to understand why technological advancements leading to changes in implants do not influence clinical outcomes. Level of evidence: III.

Keyword

Shoulder; Arthroplasty; Hospitals; District