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Shoulder Arthroplasty Data: Is it Really Important to Evaluate It?

Niel Kang of Addenbrookes Hospital and Olga Taylor, of ODEP asked the question – “Why do we need to evaluate shoulder arthroplasty data?” – since there is a worldwide, exponential, growth of shoulder arthroplasty procedures.

According to some data, in such fertile environment, there may be an outsider or two that could create scenarios, such as witnessed in other orthopedic subspecialties, such as 3M Capital and the metal-on-metal hip misery.

There is an increasing influence of procurement agencies upon decision-making implant use within surgical departments. Surgeons and industry are determined that the evidence that such agencies use to make those decisions are clinically based and not on cost effectiveness.

BESS has been growing in numbers of surgeon members and is establishing a glowing reputation for producing the highest-quality research while working with allied health professionals to design clinical commissioning documents that benefit the patient, both individually to reduce variation of care and system-wide to prevent a “postcode lottery” of delivering a shoulder service. At the same time, BESS have proactively approached the UK NJR and ODEP to create a benchmarking system that will help to reward the collection of surgical outcomes in this orthopedic procedure and its analysis, with a “benchmark” that can be applied internationally.

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Which shoulder arthroplasty data should be evaluated?

Since nowadays there’s a wide variety of options, the bipartisan decision between shoulder surgeons and industry has begun with reverse shoulder arthroplasty. Unlike the total hip arthroplasty, shoulder arthroplasty does not use standard components, so the shoulder surgeons may replace the glenoid depending on patient and surgical factors.

Shoulder arthroplasty represents “the last chance saloon”, where patients may have complications from their surgery, but the surgeon will not review the implant because it is technically difficult, resource-demanding and may not improve the outcome.

The study ideally indicates that the industry should submit data from all sources, which may include but it’s not exclusive to UK NJR, but since there is a relative youth of certain shoulder implants, they also recommend data being independent of the designing center(s).

 

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