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DOES HEALTHCARE SETTING INFLUENCE OUTCOMES FOLLOWING SHOULDER ARTHROPLASTY?

Version 2 2024-06-03, 18:24
Version 1 2023-05-18, 23:05
conference contribution
posted on 2024-06-03, 18:24 authored by N Paltoglou, Richard PageRichard Page, Stephen GillStephen Gill
In Australia nearly two-thirds of arthroplasty procedures are performed in the private setting, which is disproportionate to the dimensioning 43.5% of the population with private health cover. The rapid growth of shoulder arthroplasty surgery will be absorbed by both private and public sectors. This study aimed to assess the influence of healthcare setting on elective shoulder arthroplasty outcomes, defined by revision rate, and functional measures.Data was collected on all primary procedures performed from 2004 – 2019 within a regional area of Victoria, Australia. Patients were categorised into private or public settings. Trauma cases for acute proximal humerus fractures were excluded. The primary outcome of revision surgery was recorded as a cumulative percentage, and survival analysis conducted to calculate a hazard ratio (HR). Functional outcomes were measured through range-of-motion (ROM) and multiple validated patient-reported-outcome-measures (PROMs).458 patients were identified in the study: 290 private and 168 public. There was no difference in the revision rate (3.8% private, 4.8% public), with an adjusted HR of 1.25 (p=0.66) for public compared to private. Baseline and post-operative functional measures were significantly greater in the private setting for ROMs and PROMs analysis, in particular post-operative QuickDASH (15.9±14.7 to 32.7±23.5; p<0.001) and Oxford Shoulder Score (42.6±6.3 to 35.7±11.2; p<0.001). However, there was no significant difference for any of the functional measures in the amount of change from baseline to 12-months between settings.Although healthcare setting does not appear to influence revision rate for shoulder arthroplasty, clear differences were demonstrated for functional measures both pre and post operatively. This may be attributed to factors such as access to perioperative rehabilitation and should be an area to target future investigations.

History

Volume

105-B

Pagination

33-33

Location

Christchurch, New Zealand

Start date

2022-10-31

End date

2022-11-03

ISSN

1358-992X

eISSN

2049-4416

Language

en

Publication classification

E3 Extract of paper

Title of proceedings

Orthopaedic Proceedings

Event

The New Zealand Orthopaedic Association and the Australian Orthopaedic Association (NZOA AOA) Combined Annual Scientific Meeting

Issue

SUPP_3

Publisher

British Editorial Society of Bone & Joint Surgery

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