Increasing Incidence of Primary Reverse and Anatomic Total Shoulder Arthroplasty in the United States.

Abstract Background The purpose of this study was to determine the incidence of primary reverse and anatomic total shoulder arthroplasty in the United States and to examine changes in age and gender-based procedure rates. A secondary goal was to determine the incidence of hemiarthroplasty. Methods Using nationally representative data along with United States Census data, we identified over 508 thousand cases of primary reverse and anatomic total shoulder arthroplasty and shoulder hemiarthroplasty from 2012 to 2017. Trends in incidence for each procedure were analyzed and gender-adjusted and age-adjusted procedure rates were calculated. Results From 2012 to 2017, the population-adjusted incidence of primary reverse total shoulder arthroplasty increased from 7.3 cases per 100,000 (22,835 procedures) to 19.3 cases per 100,000 (62,705 procedures), anatomic total shoulder arthroplasty increased from 9.5 cases per 100,000 (29,685 procedures) to 12.5 cases per 100,000 (40,665 procedures), and hemiarthroplasty decreased from 3.7 cases per 100,000 (11,695 procedures) to 1.5 cases per 100,000 (4,930 procedures). These trends were observed among males and females, as well as all age groups. The greatest increase in incidence was seen in males as well as patients 50-64 years old undergoing reverse total shoulder arthroplasty. Conclusion The incidence of primary reverse and anatomic total shoulder arthroplasty have increased substantially in the United States from 2012-2017 while the incidence of hemiarthroplasty has decreased. Level of Evidence Epidemiology Study; Large Database Analysis