Document Type

Conference Proceeding

Publication Date

4-11-2024

Abstract

PURPOSE: This study sought to use an all-payor inpatient claims database to investigate the incidence and national cumulative costs of revision shoulder arthroplasty in the United States, including those being performed for PJI. In addition, we also aimed to project the incidence and national economic impact of revision shoulder arthroplasty in the US through 2030. METHODS: The National Inpatient Sample (NIS) was used to estimate the annual number of revision shoulder arthroplasties performed between 2008 and 2019 using ICD procedure codes. Cumulative national costs were estimated. Septic revision shoulder arthroplasties were identified (i.e., cases being done for a prosthetic joint infection). Independent Poisson and linear regression models were used to project the future incidence and national cumulative cost for revision shoulder arthroplasty and septic revision shoulder arthroplasty. RESULTS: Between 2008 and 2019, the annual incidence of all-cause revision TSA increased from 4,066 to 12,200 and septic revision TSA increased from 818 to 3,520. Infection represented 20.0% of all revision cases in 2008, which increased to 28.9% of all cases in 2019. The yearly national cumulative cost for all-cause revision TSA increased from 75 million dollars in 2008 to 253 million dollars in 2019. Likewise, the national cumulative cost associated with PJI increased from 14 million dollars in 2008 to 81 million dollars in 2019. By 2030, the linear model predicted that the volume of all-cause revision TSA will increase to 19,046 cases/year and the Poisson model predicted the volume will increase to 32,366 cases/year. The projections for septic revision TSA demonstrated increases by the linear and Poisson models to an estimated 5,789 and 14,771 procedures by 2030. The national cumulative cost of all-cause revision TSA is predicted to increase to 400-753 million dollars per year by 2030. Septic revision TSA is expected to have a cumulative cost burden of 141-475 million dollars by 2030. CONCLUSION: From 2008-2019, there has been a dramatic rise in the incidence of revision shoulder arthroplasty in the US with a significant projected economic burden. This study provides a more complete picture of the impact that shoulder arthroplasty has and will have on the US healthcare system and will help determine the proper allocation of healthcare resources for the future.

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Mid-America Orthopaedic Association 41st Annual Meeting, April 10-14, 2024, Bonita Springs, FL

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