Shoulder replacement surgery surges in Sweden, with major shifts in procedure types
Swedish surgeons performed nearly 29,000 shoulder replacements over 16 years, with rates more than doubling and women undergoing procedures at far higher rates than men. The shift toward newer surgical techniques signals both changing clinical practices and potential opportunities for medical device makers targeting orthopedic markets.
Originaltitel: Primary shoulder arthroplasty trends in Sweden: a 16-year observational study from 2008 to 2023.
Axelprotesvolymen i Sverige kommer att fortsätta växa kraftigt — mellan 2008 och 2023 mer än fördubblades antalet primära axelprotesoperationer från 13,2 till 32,7 per 100 000 invånare. Studien från Danderyd sjukhus och Karolinska Institutet analyserade 28 632 operationer ur Svenska Skuldraprotesregistret och visar att kvinnor genomgår proceduren i större omfattning (41,2 per 100 000 år 2023) än män (24,2). Användningen av omvänd axelprotesmodell (RTSA) ökar markant och är nu vanligaste valet för patienter över 65 år, medan anatomiska protesmodeller (HA) och cementerad fixering minskar konsekvent. Trenderna beräknas fortsätta till 2030. För inköp av protesmaterial och operationsplanering innebär detta växande behov av RTSA-kapacitet och utfasning av äldre fixeringsmetoder. Regionerna bör anpassa lagerhållning och leverantörskontrakt därefter.
BACKGROUND: Primaryshoulder arthroplasty is increasingly used to treat degenerative and traumatic shoulder conditions. This study aims to analyze incidence trends of primary shoulder arthroplasty in Sweden from 2008 to 2023 and to evaluate temporal changes in surgical and fixation methods, with projections for future incidence rates through 2025 and 2030. METHODS: A retrospective, population-based study combining data from the Swedish National Patient Register (NPR) and the Swedish Shoulder Arthroplasty Register (SSAR). All patients aged ≥ 15 years undergoing primary shoulder arthroplasty between January 1, 2008 and December 31, 2023 were included. Incidence rates were calculated per 100,000 inhabitants, and regression modelling based on best fit were used to assess temporal trends and projections through 2030. RESULTS: 28,632 primary shoulder arthroplasties were performed (women: 18,569; men: 10,063). Overall incidence increased from 13.2 to 32.7 per 100,000. Women had higher increases in absolute incidence rates (17.4 to 41.2) while men showed a greater relative increase (8.8 to 24.2). HA declined steadily, becoming the least used method. Usage of RTSA increased, becoming the most common method in individuals aged ≥ 65 years. Cemented fixation declined across both age groups. CONCLUSION: The incidence of primary shoulder arthroplasty in Sweden more than doubled between 2008 and 2023, with a shift towards RTSA, away from HA and cemented fixation. Projections indicate continued growth through 2030.