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. 2022 Sep 30;23(1):889.
doi: 10.1186/s12891-022-05849-x.

Shoulder replacement: an epidemiological nationwide study from 2009 to 2019

Umile Giuseppe Longo  1   2 , Rocco Papalia  3   4 , Alessandro Castagna  5 , Sergio De Salvatore  3   4 , Enrico Guerra  6 , Ilaria Piergentili  3   4 , Vincenzo Denaro  3   4
Affiliations

Shoulder replacement: an epidemiological nationwide study from 2009 to 2019

Umile Giuseppe Longo et al. BMC Musculoskelet Disord. .

Abstract

Background: Shoulder replacement (SR) constitutes the gold standard treatment for severe shoulder diseases, including osteoarthritis, rheumatoid arthritis, complex fractures, avascular necrosis and rotator cuff arthropathy. Although several countries have national registries, there is a lack of epidemiological data on SR. Sharing national statistics and correlating those to other countries could be helpful to compare outcomes and costs internationally. This paper aims to evaluate the trend of hospitalizations for SR (both first implants and revisions of anatomical and reverse prosthesis) in Italy from 2009 to 2019, based on the National Hospital Discharge Reports (S.D.O) provided by the Italian National Health Service (INHS). Moreover, the economic impact on the healthcare system of SR and SR revisions was assessed, providing a statistical prediction for the next ten years.

Methods: The data used in this paper were about patients who underwent Total Shoulder Replacement (TSR), Shoulder Hemiarthroplasty (SH) or Revision of shoulder joint replacement (RSR) from 2009 to 2019 in Italy. Information about patients was anonymous and included age, sex, days of hospitalization, procedures and diagnoses codes.

Results: From 2009 to 2019, 73,046 TSR and SH were performed in adult Italian residents, with a cumulative incidence of 13.6 cases per 100,000 adult Italian residents. While, 2,129 revisions of shoulder replacement were performed, with a cumulative incidence of 0.4 cases per 100,000 residents. Overall, females represented the majority of the cases (72.4% of patients who underwent TSR or SH and 59.1% of patients who underwent RSR). From 2009 to 2019, has been assessed an overall cost of 625,638,990€ for TSR or SH procedures in Italy. While, an overall cost of 9,855,141€ for RSR procedures in Italy was calculated.

Conclusions: The incidence of SR and RSR is expected to increase in the following years, constituting a burden for the healthcare systems. Overall, in Italy, the females represented the majority of patients. Further prospective studies on this topic in different countries can be con-ducted to make comparisons.

Keywords: Costs; Epidemiology; Italy; Revision of shoulder joint replacement; Shoulder Hemiarthroplasty; Shoulder replacement; Total Shoulder Replacement.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Incidence of TSR and SH procedures per 100,000 residents from 2009 to 2019
Fig. 2
Fig. 2
Frequencies of TSR and SH divided by age group
Fig. 3
Fig. 3
Average days of hospitalization by years of TSR and SH procedures
Fig. 4
Fig. 4
Average days of hospitalization by age groups of TSR and SH procedures
Fig. 5
Fig. 5
TSR and SH procedures by years
Fig. 6
Fig. 6
Forecast model from 2019 to 2030 of TSR and SH procedures
Fig. 7
Fig. 7
Incidence of RSR procedures per 100,000 residents from 2009 to 2019
Fig. 8
Fig. 8
Frequencies of RSR divided by age group
Fig. 9
Fig. 9
Average days of hospitalization by years of RSR procedures
Fig. 10
Fig. 10
Average days of hospitalization by age groups of RSR procedures
Fig. 11
Fig. 11
Forecast model from 2019 to 2030 of RSR procedures
Fig. 12
Fig. 12
Estimated costs of TSR and SH procedures from 2009 to 2030
Fig. 13
Fig. 13
Estimated costs of RSR procedures from 2009 to 2030
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