Establishing an institutional reverse total shoulder arthroplasty registry

Abstract

Background: The number of implanted reverse total shoulder arthroplasties (RTSA) is increasing worldwide. To improve patient care, institutional and national arthroplasty registries are being established worldwide to record outcome data. This article aims to describe the setup of an RTSA database in a high-volume university orthopedic hospital. Methods: All patients who received an RTSA at the authors’ tertiary referral hospital have been followed and individual datasets have been systematically recorded in a REDCap database since 2005. The data are captured longitudinally as a primary preoperative survey and as a regular or irregular postoperative follow-up. All baseline demographic data, patient history, surgical details, arthroplasty details, adverse events, and radiographic and clinical outcome scores (Constant–Murley score, Subjective Shoulder Value, range of motion) are recorded. Results: A total of 1433 RTSA were implanted between January 2005 and December 2020. Of these, 1184 (83%) were primary implantations and 249 (17%) were secondary cases. The cohort had a mean age of 70 ± 10 years, was 39% male, and was classified ASA II in 59%. The lost to follow-up rate was 18% after 2 years, 22% after 5 years, and 53% after 10 years. The overall complication rate with 2 years minimum follow-up was 18% (156/854 shoulders) with reintervention in 10% (82/854 shoulders). Conclusion: A well-managed institutional arthroplasty registry, including structured clinical and radiological follow-up assessments, offers the opportunity for high-quality long-term patient and arthroplasty outcome analysis. Such data are not only helpful for analyzing patient outcome and implant survival, but will be increasingly important to justify our daily clinical practice against different stakeholders in the various health care systems.