The Swedish Shoulder Arthroplasty Register.

An analysis of 255 re-operations on

arthroplasties reported to the register.

Ulf Lillkrona MD PhD Anders Nordqvist MD PhD

Hans Rahme MD PhDBjörn Salomonsson MD

The Swedish Shoulder and Elbow Society Board of Quality Registers

1999-2006

Experiences of 8 years

THE REGISTER

• Started 1999• All Swedish hospitals except 2

participates.• Is owned by the Swedish Shoulder

and Elbow Society.• Covers more than 90% in Sweden.

REPORTS 1999 -2006

Total 4238 reports (285 / 3953)

Primary arthroplasty93%

Re-operation7%

MOST COMMON DIAGNOSES

731

1215

1432

0

200

400

600

800

1000

1200

1400

1600

Reumatoid OsteoArthritis Fracture

The most common diagnoses

RE-OPERATIONS

Revison/Reoperation 285 st (243 / 42)

Revision85%

Other re-op15%

133 WITH INDEX 1999-2006

133 reop since 1999 (118 / 15)

Index report89%

No report11%

REASON FOR RE-OPERATION

Reason for Re-operation

16,5%

6,3%

2,1%

4,2%6,7%

1,8%

20,7%

2,1%3,9%

Glenoid erosion

Pain

Loose glenoid

Loose stem

Infection

Periprostetic fx

Instability

Loose tubercle

Cuff insuff

RE-OPERATION

Re-operation procedure

17,5%

6,0%0,7%

7,4%

0,7%

1,4%

1,1%

2,5%

4,9%

2,1%1,4% 1,4%

Change Stem

Change mod-Caput

Change Glenoid

Glenoid insert

Delta plastic change

Spacer

Lavage

Extraktion Implant

Other soft tissue

Arthroscopy

Refix Tubercles

Closed reduction

RE-OPERATION / DIAGNOSE

Re-operation burden / Diagnose

6,5%

4,8%

4,4%

3,4%3,1%

2,1% 2,0%

1,5%

0,0%

1,0%

2,0%

3,0%

4,0%

5,0%

6,0%

7,0%

CuffArthropathy

Nonunion Ostenecrosis Reumatoid Osteoartrosis Fracture Malunion Other

DIAGNOSE / MEAN TIME TO RE-OPERATION

Diagnose / Time to re-op (years)

1,2 1,2

1,8 1,8

2,42,6

4,7

0

0,5

1

1,5

2

2,5

3

3,5

4

4,5

5

Cuff Arthropathy Fracture Malunion Nonunion Ostenecrosis Osteoartrosis Reumatoid

IMPLANTS

Implants: Prim op / Re-operation

49

210

395

108

255

594

694

534

80

232

319

8971

44

166

7 17 15 3 14 21 18 12 3 8 11 1 1 1 10

100

200

300

400

500

600

700

800

Bipolar Delta-3 Neer 2 Neer 3 Global

3M-ModularBigliani-Flatow

NottinghamGlobal AdvGlobal Fx

Tornier Aequalis

Tornier Fx

Anatomical/Sulzer

Global CapCopeland

Prim-op

Re-op

IMPLANTS

Implants / Re-operation burden

14,3%

8,1%

3,8%

2,8%

5,5%

3,5%

2,6%2,2%

3,8% 3,4% 3,4%

1,1% 1,4%

2,3%

0,6%

0,0%

2,0%

4,0%

6,0%

8,0%

10,0%

12,0%

14,0%

16,0%

Bipolar Delta-3 Neer 2 Neer 3 Global

3M-ModularBigliani-Flatow

NottinghamGlobal AdvGlobal Fx

Tornier Aequalis

Tornier Fx

Anatomical/Sulzer

Global CapCopeland

CONCEPT / REVISION BURDEN

Revision

2,6%

5,7%

2,2%

4,1%

0,0%

1,0%

2,0%

3,0%

4,0%

5,0%

6,0%

Index op All reports

Hemi

Total

CONCEPT / REVISION BURDEN

Concept / Revision burden

10,2%

4,8%

2,5%

1,1%

0,0%

2,0%

4,0%

6,0%

8,0%

10,0%

12,0%

Bipolar (n=49) Delta-3 (n=210) Hemi (n= 3147) Total (n=476)

CONCEPT/GLENIOD PROBLEM

Glenoid Erosion / Loosening-Wear

2,0%

2,4%

1,7%

0,8%

0,0%

0,5%

1,0%

1,5%

2,0%

2,5%

Bipolar Delta-3 Hemi Total

CONCLUSION

• The Swedish Shoulder Arthroplasty Register now has a possibility to analyse revision rate and reason to re-operations for different implants as well as diagnoses.

THANK YOU!

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www.ssas.se/axel