Shoulder implant registries

The first shoulder implant registry started in Finland in 1980, Norway followed in 1994 and nowadays a shoulder registry exists in the United Kingdom, Denmark, Norway, Sweden, Finland, the Netherlands, New Zealand, Australia, Germany, Portugal, and the Kaiser Permanente in California. Registries were set up to detect poor prosthetic designs at an early stage and to provide for the track and traceability of these prostheses. Currently registries are used for implant surveillance, and to assess incidence, indication, type of procedure and revision. The available data can help to estimate the future economic impact on our health care systems, and they can also be used to provide information to benchmark shoulder arthroplasty for ODEP. Existing registries report on surgeon-derived measures, as key-outcome is revision, but there is an increasing demand of all stakeholders for more patient focused outcome measurements. Ideally registries should relate to patient derived outcome measurements as PROMs to enable us to analyze clinical outcome. In several countries the PROMs are already linked to the registry. Long-term follow-up is required to exhibit differences in outcome and problems with procedures and implants leading to revision surgery. From what is known from existing national registries, there are large variations in indications and type of surgery. Comparative analysis of national registries is difficult as there is a difference in the parameters and outcome measurements recorded. Merging data from different national registries into a common database would enable us to compare incidence, indication, procedure, but also results, and the higher number of cases in such a database would improve the statistical strength of studies. However, this can only be obtained if we agree to use a similar set of variables and outcome measurements.

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