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. 2019 Jun;90(3):196-201.
doi: 10.1080/17453674.2019.1597491. Epub 2019 Apr 1.

Low revision rate despite poor functional outcome after stemmed hemiarthroplasty for acute proximal humeral fractures: 2,750 cases reported to the Danish Shoulder Arthroplasty Registry

Alexander Amundsen  1 , Jeppe V Rasmussen  1 , Bo S Olsen  1 , Stig Brorson  2
Affiliations

Low revision rate despite poor functional outcome after stemmed hemiarthroplasty for acute proximal humeral fractures: 2,750 cases reported to the Danish Shoulder Arthroplasty Registry

Alexander Amundsen et al. Acta Orthop. 2019 Jun.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Acta Orthop. 2019 Dec;90(6):626. doi: 10.1080/17453674.2019.1676517. Epub 2019 Oct 15. Acta Orthop. 2019. PMID: 31613167 Free PMC article. No abstract available.

Abstract

Background and purpose - The revision rate of stemmed hemiarthroplasty (SHA) for acute proximal humeral fractures is low, but does not necessarily reflect the functional outcome. We report the revision rate of SHA for acute proximal humeral fractures and the proportion of arthroplasties that are not revised despite low functional outcome scores. Patients and methods - The Danish Shoulder Arthroplasty Registry was used to identify all patients with a proximal humeral fracture that was treated with a SHA between January 1, 2006 and December 31, 2015. Information on demographics, surgical procedures, and revisions was collected by the registry. The Western Ontario Osteoarthritis of the Shoulder (WOOS) index at 1 year was used as functional outcome score. We converted the score to a percentage of a maximum score with 100 being the best. Results - 2,750 SHAs in 2,719 patients were included. Mean age was 72 years (SD 11); 79% were women. Mean WOOS at 1 year was 55 (SD 26). A total of 101 (4%) arthroplasties were revised, and the 10-year cumulative implant survival rate was 95%. The Cox regression model showed a statistically significant impact on implant survival of age, but not of sex or arthroplasty brand. A WOOS score below 30 and 50 was reported in 11% and 25% of patients, respectively. Interpretation - We found a high implant survival rate, but also a high proportion of patients with a low functional outcome score 1 year after surgery.

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Figures

Figure 1.
Figure 1.
Annual number of SHAs for acute proximal humeral fractures in Denmark from 2006 to 2015.
Figure 2.
Figure 2.
Distribution of WOOS scores. Red lines signify a WOOS score of 30 and 50.
Figure 3.
Figure 3.
The 10-year cumulative implant survival rate and CI for patients younger than 55 years (blue), patients between 55 and 74 years (green), and patients older than 75 years (red) (p < 0.01).
See this image and copyright information in PMC

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