Safety and Effectiveness of Shoulder Arthroplasties in Spain: A Systematic Review

Jorge Arias-De La Torre,Antonio J Molina,Carles Torrens,Vicente Martín,Francesc Pallisó,Jonathan P Evans,Elisa Puigdomenech,Jose María Valderas,Kayla Smith,Xavier Garcia,Laura Muñoz-Ortiz,Arantxa Romero-Tamarit,Mireia Espallargues,Miquel Pons-Cabrafiga

doi:10.3390/jcm8122063

Abstract

The effectiveness and safety of shoulder arthroplasties in the general context of a Spanish patient population remains unclear. The aim of this study was to ascertain both the effectiveness and safety of primary shoulder arthroplasties and the prosthesis types used in Spain. A systematic review of all the available literature evaluating the effectiveness and safety of primary shoulder arthroplasties in Spain was performed. A narrative synthesis was performed, and evidence tables were created in four dimensions: study design, arthroplasty characteristics, safety, and effectiveness. Orthopaedic Data Evaluation Panel (ODEP) scores were used to evaluate prosthesis types. Twenty-one studies were selected that included a total of 1293 arthroplasties. The most common indication was fractures, while the prosthesis most frequently used was the Delta Xtend (ODEP 10A). The most common complication was scapular notching. Prosthesis revision rate was approximately 6% for follow-ups between 12 and 79 months. In addition, significant improvements were observed in the Constant–Murley test score after the intervention. Currently in Spain, shoulder arthroplasty can be considered a safe and effective procedure with functional recovery and pain reduction for eligible patients with humeral fracture, rotator cuff arthropathy, fracture sequelae and malunion of the proximal humerus, and degenerative disease. Future longitudinal research and population-based studies could serve to confirm these results and identify points of improvement.

Highlights

Shoulder arthroplasty is currently considered to be an established therapeutic option and an effective and efficient procedure to improve physical function, pain and quality of life in patients [1,2,3,4,5]
A systematic review was conducted on the results of shoulder arthroplasties performed in public hospitals in Spain, and the results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria [21]
The results of the review show that shoulder arthroplasty in Spain can currently be considered an effective and safe procedure, with functional recovery and pain reduction in patients operated on for humeral fracture and rotator cuff arthropathy, fracture sequelae and malunion of the proximal humerus, and degenerative diseases

Summary

Introduction

Shoulder arthroplasty is currently considered to be an established therapeutic option and an effective and efficient procedure to improve physical function, pain and quality of life in patients [1,2,3,4,5]. Previous research has proposed that the three most common complications are instability, periprosthetic fracture and infection [12,13,14]. Understanding this information within the context of the effectiveness of different types of prostheses and models, and in certain population groups, is likely to be highly relevant [1,7,14]. There is no arthroplasty register that can be directly assessed Both analysing the results of these procedures by population and establishing a registry could be useful in evaluating the results of shoulder arthroplasties more precisely in a specific healthcare context such as Spain, facilitating a comparison to other international contexts

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