Longitudinal changes in shoulder arthroplasty stratified by age groups, types of surgical facilities, and geographical regions in Korea from 2010 to 2020

Yong-Beom Kim; Hyung-Suk Choi; Suyeon Park; Gee Chul Park; Gi-Won Seo

doi:10.1016/j.jse.2023.04.008

Longitudinal changes in shoulder arthroplasty stratified by age groups, types of surgical facilities, and geographical regions in Korea from 2010 to 2020

J Shoulder Elbow Surg. 2023 Nov;32(11):e565-e570. doi: 10.1016/j.jse.2023.04.008. Epub 2023 May 26.

Authors

Yong-Beom Kim¹, Hyung-Suk Choi¹, Suyeon Park², Gee Chul Park¹, Gi-Won Seo³

Affiliations

¹ Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
² Department of Biostatistics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea; Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea.
³ Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea. Electronic address: 102980@schmc.ac.kr.

PMID: 37245622
DOI: 10.1016/j.jse.2023.04.008

Abstract

Background: Shoulder arthroplasty (SA), including hemiarthroplasty, reverse and anatomical total SA (TSA), improves quality of life by reducing shoulder pain and restoring function in patients not only with irreparable rotator cuff tears and/or cuff tear arthropathy but also with osteoarthritis posttraumatic arthritis, proximal humeral fractures, etc. Given the rapid developments in artificial joints and improvements in postoperative outcomes, the number of SA surgeries is increasing worldwide. Therefore, we investigated changes in trends over time in Korea.

Methods: We analyzed the longitudinal changes in the incidence of SA including anatomic and reverse TSA, hemiarthroplasty, and shoulder revision arthroplasty (SRA) by changes in the Korean age profile, surgical facilities, and geographical regions using the Korean Health Insurance Review and Assessment Service database from 2010 to 2020. Data were also collected from the National Health Insurance Service and the Korean Statistical Information Service.

Results: From 2010 to 2020, the TSA rate per 1,000,000 person-years increased from 10.571 to 101.372 (time trend = 1.252; 95% CI 1.233-1.271, P < .001). The shoulder hemiarthroplasty (SH) rate per 1,000,000 person-years decreased from 6.414 to 3.685 (time trend = 0.933; 95% CI 0.907-0.960, P < .001). The SRA rate per 1,000,000 person-years increased from 0.792 to 2.315; the increase was significant (time trend = 1.133; 95% CI 1.101-1.166, P < .001).

Discussion: Overall, TSA and SRA are increasing and SH is decreasing. For both total TSA and SRA, steep increases are evident in the numbers of patients in their 70s and older than 80 years. The SH trend is decreasing regardless of differences in age groups, surgical facilities, and geographical regions. SRA is preferentially performed in Seoul.

Keywords: Incidence; Korea; database; longitudinal change; national trend; shoulder arthroplasty.