Our Summary

This study aimed to predict the future demand for shoulder replacement surgeries in England and to examine differences in the availability of services and patient outcomes based on location and socioeconomic status. The researchers looked at data for all shoulder replacements conducted by the NHS from 1999 to 2020 for patients aged 18 and above, excluding those for cancer or acute trauma. According to their findings, the rate of shoulder replacements has quadrupled from 1999 to 2020, particularly among patients over 65 years old. They also found that 1 in 6 patients had to travel to a different region for their surgery, indicating unequal access to services. The risk of serious complications within 30 and 90 days after surgery also increased over time. Moreover, patients from more deprived socioeconomic groups were found to have a higher risk of complications and repeat surgery. The researchers predict that shoulder replacements could increase by up to 234% by 2050, costing hospitals £235 million per year. These findings suggest a need for better healthcare planning to meet local demand and more research to understand and prevent the rise in complications.

FAQs

  1. What does the study predict about the future demand for shoulder replacement surgeries in England?
  2. What does the study suggest about the access to shoulder replacement surgeries based on location and socioeconomic status?
  3. What are the findings regarding the risk of complications after shoulder replacement surgeries?

Doctor’s Tip

A helpful tip a doctor might give to a patient undergoing shoulder replacement surgery is to follow the post-operative rehabilitation plan diligently. This typically includes physical therapy exercises to improve range of motion, strength, and stability in the shoulder joint. Consistency in performing these exercises can help speed up recovery and improve overall outcomes after surgery. It’s important to communicate any concerns or difficulties with your healthcare team to ensure a successful recovery process.

Suitable For

Patients who are typically recommended for shoulder replacement surgery include those with severe shoulder pain and stiffness that limits daily activities, as well as those who have not had success with non-surgical treatments such as physical therapy, medications, and injections. Common conditions that may necessitate shoulder replacement surgery include osteoarthritis, rheumatoid arthritis, avascular necrosis, severe fractures, and rotator cuff tears.

Additionally, patients who are older and have a higher risk of complications may be recommended for shoulder replacement surgery if the potential benefits outweigh the risks. Patients with certain medical conditions such as diabetes, obesity, and heart disease may also be considered for shoulder replacement surgery, but their overall health status will be carefully assessed before proceeding with the procedure.

Overall, the decision to recommend shoulder replacement surgery is based on a thorough evaluation of the patient’s symptoms, medical history, and overall health status, as well as the potential benefits and risks of the procedure. It is important for patients to discuss their options with their healthcare provider to determine if shoulder replacement surgery is the right choice for them.

Timeline

Before shoulder replacement surgery:

  1. Patient experiences chronic shoulder pain, stiffness, and limited range of motion.
  2. Patient undergoes various non-surgical treatments such as physical therapy, medications, cortisone injections, and lifestyle modifications.
  3. Patient’s condition worsens over time, leading to consideration of surgery as a last resort.

After shoulder replacement surgery:

  1. Patient undergoes pre-operative assessments and consultations with the surgeon.
  2. Surgery is performed to replace the damaged shoulder joint with an artificial implant.
  3. Patient undergoes post-operative rehabilitation and physical therapy to regain strength and function in the shoulder.
  4. Patient experiences gradual improvement in pain, range of motion, and function over time.
  5. Patient may need to make lifestyle modifications and follow-up appointments with healthcare providers for long-term care and monitoring of the artificial joint.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with shoulder replacement surgery?
  2. What is the expected recovery time and rehabilitation process after shoulder replacement surgery?
  3. How long can I expect the shoulder replacement to last before needing a revision surgery?
  4. Will I need to make any lifestyle changes or modifications after the surgery?
  5. Are there any alternative treatments or therapies that could be considered before opting for shoulder replacement surgery?
  6. What is the success rate of shoulder replacement surgeries at this hospital or practice?
  7. How many shoulder replacement surgeries does the surgeon perform annually?
  8. What is the post-operative care plan, including pain management and physical therapy?
  9. How will my overall health and any pre-existing conditions affect the success of the surgery?
  10. What is the expected outcome in terms of pain relief and improved mobility following the surgery?

Reference

Authors: Valsamis EM, Pinedo-Villanueva R, Sayers A, Collins GS, Rees JL. Journal: BMC Med. 2023 Oct 26;21(1):406. doi: 10.1186/s12916-023-03112-1. PMID: 37880689