Utilisation of shoulder arthroplasty in the UK.
OBJECTIVE
To estimate the per capita utilisation of shoulder prostheses in the UK and to compare UK figures to those from the US.


METHODS
A postal and telephone survey was undertaken of all hospitals in the UK carrying out orthopaedic operations. The relative usage of total shoulder replacement and hemi-arthroplasty for both elective and trauma indications were analysed and UK figures compared to those from the US.


RESULTS
There were 281 replies from 314 questionnaires, a response rate of 90%. The per capita rate of shoulder replacement is approximately one-tenth for total replacement and one-fifth for hemiarthroplasty compared to the US, suggesting that there is an unmet demand in the UK. In the US, the proportion of total replacements to hemi-arthroplasties for elective indications is approximately equal whereas in the UK there are twice as many hemi-arthroplasties, which raises the question as to whether hemi-arthroplasties are being used when a total replacement might be preferable. The numbers of shoulder arthroplasties implanted by individual surgeons and units is, except for a few large centres, small. Consequently, it is much more difficult for the surgeon to evaluate the various prosthetic designs and surgical techniques.


CONCLUSIONS
There is a need for a national register to increase the knowledge about such designs and techniques and to analyse risk factors.
Department of Orthopaedics, St George's Hospital, London, UK. mattravenscroft@doctors.org.uk
Matt
M
Ravenscroft
Paul
P
Calvert
D019643:Arthroplasty, Replacement / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007595:Joint Prosthesis / Q000706:statistics & numerical data*; D012785:Shoulder Joint; D011795:Surveys and Questionnaires; D006113:United Kingdom