Does body mass index influence long-term outcomes after anatomic total shoulder arthroplasty?

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Abstract

As of 2018, upwards of 42% of the US adult population was considered obese based on body mass index (BMI) scales. With the annual number of total joint replacements increasing, this study aimed to evaluate the impact BMI has on anatomic total shoulder arthroplasty (aTSA) outcomes.

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Most cited references 31

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Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018.

Craig Hales, Margaret Carroll, Cheryl D Fryar … (2020)

Obesity is associated with serious health risks (1). Severe obesity further increases the risk of obesity-related complications, such as coronary heart disease and end-stage renal disease (2,3). From 1999-2000 through 2015-2016, a significantly increasing trend in obesity was observed (4). This report provides the most recent national data for 2017-2018 on obesity and severe obesity prevalence among adults by sex, age, and race and Hispanic origin. Trends from 1999-2000 through 2017-2018 for adults aged 20 and over are also presented.

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Increasing incidence of shoulder arthroplasty in the United States.

Yuqing Zhang, Sarah B Wise, H. Kim … (2011)

The number of total shoulder arthroplasties performed in the United States increased slightly between 1990 and 2000. However, the incidence of shoulder arthroplasty in recent years has not been well described. The purpose of the present study was to examine recent trends in shoulder hemiarthroplasty and total shoulder arthroplasty along with the common reasons for these surgical procedures in the United States. We modeled the incidence of shoulder arthroplasty from 1993 to 2008 with use of the Nationwide Inpatient Sample. On the basis of hemiarthroplasty and total shoulder arthroplasty cases that were identified with use of surgical procedure codes, we conducted a design-based analysis to calculate national estimates. While the annual number of hemiarthroplasties grew steadily, the number of total shoulder arthroplasties showed a discontinuous jump (p < 0.01) in 2004 and increased with a steeper linear slope (p < 0.01) since then. As a result, more total shoulder arthroplasties than hemiarthroplasties have been performed annually since 2006. Approximately 27,000 total shoulder arthroplasties and 20,000 hemiarthroplasties were performed in 2008. More than two-thirds of total shoulder arthroplasties were performed in adults with an age of sixty-five years or more. Osteoarthritis was the primary diagnosis for 43% of hemiarthroplasties and 77% of total shoulder arthroplasties in 2008, with fracture of the humerus as the next most common primary diagnosis leading to hemiarthroplasty. The number of shoulder arthroplasties, particularly total shoulder arthroplasties, is growing faster than ever. The use of reverse total arthroplasty, which was approved by the United States Food and Drug Administration in November 2003, may be part of the reason for the greater increase in the number of total shoulder arthroplasties. A long-term follow-up study is warranted to evaluate total shoulder arthroplasty in terms of patient outcomes, safety, and implant longevity.

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Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015.

Judd S Day, Edmund Lau, Kevin Ong … (2010)

This study examined national trends and projections of procedure volumes and prevalence rates for shoulder and elbow arthroplasty in the United States (U.S.). This study hypothesized that the growth in demand for upper extremity arthroplasty will be greater than the growth in demand for hip and knee arthroplasty and that demand for these procedures will continue to grow in the immediate future. The Nationwide Inpatient Sample (1993-2007) was used with U.S. Census data to quantify primary arthroplasty rates as a function of age, race, census region, and gender. Poisson regression was used to evaluate procedure rates and determine year-to-year trends in primary and revision arthroplasty. Projections were derived based on historical procedure rates combined with population projections from 2008 to 2015. Procedure volumes and rates increased at annual rates of 6% to 13% from 1993 to 2007. Compared with 2007 levels, projected procedures were predicted to further increase by between 192% and 322% by 2015. The revision burden increased from approximately 4.5% to 7%. During the period studied, the hospital length of stay decreased by approximately 2 days for total and hemishoulder procedures. Charges, in 2007 Consumer Price Index-adjusted dollars, increased for all 4 procedural types at annual rates of $900 to $1700. The growth rates of upper extremity arthroplasty were comparable to or higher than rates for total hip and knee procedures. Of particular concern was the increased revision burden. The rising number of arthroplasty procedures combined with increased charges has the potential to place a financial strain on the health care system. Copyright © 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.