Longitudinal Changes in Shoulder Arthroplasty Stratified by Age Groups, Types of Surgical Facilities, and Geographical Regions in Korea from 2010 to 2020.

Abstract

Shoulder arthroplasty, including hemiarthroplasty, reverse and anatomical total shoulder arthroplasty, 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 shoulder arthroplasty surgeries is increasing worldwide. Therefore, we investigated changes in trends over time in Korea. We analyzed the longitudinal changes in the incidence of shoulder arthroplasty including anatomic and reverse total shoulder arthroplasty, hemiarthroplasty, and shoulder revision arthroplasty by changes in the Korean age profile, surgical facilities, and geographical regions using the Korean Health Insurance Review and Assessment Service (HIRA) database from 2010-2020. Data were also collected from the National Health Insurance Service (NHIS) and the Korean Statistical Information Service (KOSIS). From 2010-2020, the total shoulder arthroplasty 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 < 0.001). The shoulder hemiarthroplasty 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 < 0.001). The shoulder revision arthroplasty 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 < 0.001). Overall, total shoulder arthroplasty and shoulder revision arthroplasty are increasing and shoulder hemiarthroplasty is decreasing. For both total shoulder arthroplasty and shoulder revision arthroplasty, steep increases are evident in the numbers of patients in their 70s and older than 80 years. The shoulder hemiarthroplasty trend is decreasing regardless of differences in age groups, surgical facilities, and geographical regions. Shoulder revision arthroplasty is preferentially performed in Seoul.