Lifetime Risk of Primary Shoulder Arthroplasty From 2008 to 2017: A Population-Level Analysis Using National Registry Data.

Abstract

To estimate the lifetime risk of primary shoulder arthroplasty in Australia and to examine changes over time. For this retrospective population-level analysis, de-identified individual-level data on all primary partial shoulder arthroplasty (PSA) and total shoulder arthroplasty (TSA) procedures performed in Australia from 2008 to 2017 (n = 38,868) were obtained from the Australian Orthopaedic Association National Joint Replacement Registry. Population data and life tables were obtained from the Australian Bureau of Statistics. Lifetime risk of primary shoulder arthroplasty was calculated for each year using a standardized formula. Separate calculations were undertaken by sex and for PSA and TSA. The lifetime risk of shoulder arthroplasty increased significantly over time. For men, this risk more than doubled from 0.78% (95% confidence interval [95% CI] 0.73-0.84) in 2008 to 1.78% (95% CI 1.70-1.86) in 2017. Lifetime risk for women rose from 1.54% (95% CI 1.46-1.62) to 2.88% (95% CI 2.78-2.99) over the study period. This increase was predominantly driven by growth in lifetime risk of TSA. In contrast, lifetime risk of PSA decreased over time, from 0.25% (95% CI 0.22-0.28) in 2008 to 0.11% (95% CI 0.09-0.13) in 2017 for men, and from 0.55% (95% CI 0.51-0.60) to 0.11% (95% CI 0.09-0.13) for women. By the end of 2017, the lifetime risk of primary shoulder arthroplasty in Australia increased to 1 in 57 for men and 1 in 35 for women. Compared to declining PSA trends, there was substantial growth in TSA use over a decade. These data improve our understanding of the rising national burden of primary shoulder arthroplasty and can assist in planning to meet future surgical demand.