Bradley S Schoch1, Joseph J King2, Thomas W Wright2, Stephen F Brockmeier3, Jean-David Werthel4,5, Brian C Werner3. 1. Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA. schoch.bradley@mayo.edu. 2. Department of Orthopaedic Surgery and Rehabilitation, University of Florida, Gainesville, FL, USA. 3. Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA. 4. Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA. 5. Department of Orthopedic Surgery, Hopital Ambroise Pare, Boulogne-Billancourt, France.
Abstract
PURPOSE: There is a common belief among some shoulder surgeons that the increased utilization of reverse shoulder arthroplasty (RSA) is driven by the operation being performed in younger patients. The primary purpose of this study was to evaluate the change in patient age at the time of primary RSA in the USA. METHODS: All patients undergoing primary RSA (January 2011-June 2018) were identified in the Mariner database. The mean age at the time of primary RSA was evaluated for each patient and assessed in 6-month intervals. A longitudinal comparison over time was performed for all patients. RESULTS: A total of 56,141 primary RSA were evaluated, with the mean age increasing from 69 in the 2011 to 71 in 2018 (p < 0.001). The largest increase in RSA utilization occurred in patients > 70 (1092 in 2011 to 3499 in 2018), with patients < 50 years demonstrating the slowest growth (13 in 2011 to 65 in 2018). However, when evaluated by percentage increase from 2011 to 2018, RSA volumes for patients < 60 have increased 390% compared to 220% for those > 70 years (p < 0.001). CONCLUSION: RSA continues to be performed at a similar mean age despite expanded indications and surgeon comfort. However, patients < 60 years have had a greater increase in utilization compared to patients > 70 years. The volumetric growth of RSA has largely been driven by the older population, but younger patients have shown a higher percentage of growth, which may explain the generalized observation that RSA is performed in younger patients. LEVEL OF EVIDENCE: Level III; Retrospective comparative study; Treatment study.
PURPOSE: There is a common belief among some shoulder surgeons that the increased utilization of reverse shoulder arthroplasty (RSA) is driven by the operation being performed in younger patients. The primary purpose of this study was to evaluate the change in patient age at the time of primary RSA in the USA. METHODS: All patients undergoing primary RSA (January 2011-June 2018) were identified in the Mariner database. The mean age at the time of primary RSA was evaluated for each patient and assessed in 6-month intervals. A longitudinal comparison over time was performed for all patients. RESULTS: A total of 56,141 primary RSA were evaluated, with the mean age increasing from 69 in the 2011 to 71 in 2018 (p < 0.001). The largest increase in RSA utilization occurred in patients > 70 (1092 in 2011 to 3499 in 2018), with patients < 50 years demonstrating the slowest growth (13 in 2011 to 65 in 2018). However, when evaluated by percentage increase from 2011 to 2018, RSA volumes for patients < 60 have increased 390% compared to 220% for those > 70 years (p < 0.001). CONCLUSION: RSA continues to be performed at a similar mean age despite expanded indications and surgeon comfort. However, patients < 60 years have had a greater increase in utilization compared to patients > 70 years. The volumetric growth of RSA has largely been driven by the older population, but younger patients have shown a higher percentage of growth, which may explain the generalized observation that RSA is performed in younger patients. LEVEL OF EVIDENCE: Level III; Retrospective comparative study; Treatment study.
Authors: Bradley Schoch; Jean-David Werthel; John W Sperling; Robert H Cofield; Joaquin Sanchez-Sotelo Journal: Int Orthop Date: 2016-10-14 Impact factor: 3.075
Authors: Eric R Wagner; Kevin X Farley; Ixavier Higgins; Jacob M Wilson; Charles A Daly; Michael B Gottschalk Journal: J Shoulder Elbow Surg Date: 2020-06-09 Impact factor: 3.019
Authors: Matthew J Best; Keith T Aziz; John H Wilckens; Edward G McFarland; Uma Srikumaran Journal: J Shoulder Elbow Surg Date: 2020-08-26 Impact factor: 3.019
Authors: Joseph M Statz; Bradley S Schoch; Joaquin Sanchez-Sotelo; John W Sperling; Robert H Cofield Journal: Int Orthop Date: 2017-03-30 Impact factor: 3.075
Authors: William W Schairer; Benedict U Nwachukwu; Stephen Lyman; Edward V Craig; Lawrence V Gulotta Journal: J Shoulder Elbow Surg Date: 2014-10-29 Impact factor: 3.019
Authors: Peter N Chalmers; Dane H Salazar; Anthony A Romeo; Jay D Keener; Ken Yamaguchi; Aaron M Chamberlain Journal: J Am Acad Orthop Surg Date: 2018-12-15 Impact factor: 3.020
Authors: Jenni N E Harjula; Juha Paloneva; Jaason Haapakoski; Juha Kukkonen; Ville Äärimaa Journal: BMC Musculoskelet Disord Date: 2018-07-21 Impact factor: 2.362
Authors: Adam M Gordon; Keith B Diamond; Asad M Ashraf; Matthew L Magruder; Ramin Sadeghpour; Jack Choueka Journal: Eur J Orthop Surg Traumatol Date: 2022-08-11
Authors: Adam M Gordon; Andrew R Horn; Keith B Diamond; Eric S Roth; Miriam D Weisberg; Ramin Sadeghpour; Jack Choueka Journal: Eur J Orthop Surg Traumatol Date: 2022-08-28