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Background <p>The German Shoulder and Elbow Arthroplasty Registry (SEPR) systematically collects data on shoulder arthroplasties; however, comprehensive longitudinal evaluations remain limited. This study analyzed trends in the D‑A-CH region (Germany, Austria, Switzerland) in implant selection, surgical indications, revision procedures, and cumulative revision risk using SEPR data and compared these trends with those reported in international registries.</p> Methods <p>All primary and revision shoulder arthroplasty procedures documented with the SEPR form (version&#xa0;9) from 2021 to 2023 were included. Data on implant selection, fixation technique, surgical indications, and revision events were analyzed. Kaplan–Meier estimates were used to assess 1‑ to 3‑year cumulative revision risk, stratified by prosthesis type.</p> Results <p>A&#xa0;total of 6339 primary and 760 revision procedures were analyzed. Reverse total shoulder arthroplasty (rTSA) accounted for 81% of primary cases, with anatomic total shoulder arthroplasty (aTSA) and hemiarthroplasty comprising 18.9% and 1.6%, respectively. Cementless humeral fixation was used in 76% of cases, particularly with stemless and short-stemmed implants. The most frequent indications for primary implantation were osteoarthritis (34.6%), cuff tear arthropathy (27.8%), and proximal humerus fracture (23.6%). Among revision procedures, the most common causes were infection (31.6%) and instability (24.5%). Stemmed aTSA had the highest 1‑year revision risk (11.5%), whereas stemless aTSA and rTSA showed more favorable early survivorship (0.7%–2.1%).</p> Conclusion <p>The most frequently used implant type across indication groups was rTSA, accounting for 81% of primary procedures. Most primary procedures were performed for osteoarthritis, cuff tear arthropathy, or fractures. Revisions were mainly required for infection and instability, particularly in stemmed aTSA. Early cumulative revision rates remained low overall, with lower rates observed in stemless aTSA and rTSA.</p>

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Shoulder arthroplasty registry in the German-speaking D-A-CH region: analysis of 6339 primary and 760 revision procedures between 2021 and 2023

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  • 发表日期：

    2026年6月23日

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  • Malik Jessen,
  • Milad Farkhondeh Fal,
  • Matthias Aurich,
  • Jens Kellinghaus,
  • Jörn Kircher,
  • Felix Krane

摘要

Background

The German Shoulder and Elbow Arthroplasty Registry (SEPR) systematically collects data on shoulder arthroplasties; however, comprehensive longitudinal evaluations remain limited. This study analyzed trends in the D‑A-CH region (Germany, Austria, Switzerland) in implant selection, surgical indications, revision procedures, and cumulative revision risk using SEPR data and compared these trends with those reported in international registries.

Methods

All primary and revision shoulder arthroplasty procedures documented with the SEPR form (version 9) from 2021 to 2023 were included. Data on implant selection, fixation technique, surgical indications, and revision events were analyzed. Kaplan–Meier estimates were used to assess 1‑ to 3‑year cumulative revision risk, stratified by prosthesis type.

Results

A total of 6339 primary and 760 revision procedures were analyzed. Reverse total shoulder arthroplasty (rTSA) accounted for 81% of primary cases, with anatomic total shoulder arthroplasty (aTSA) and hemiarthroplasty comprising 18.9% and 1.6%, respectively. Cementless humeral fixation was used in 76% of cases, particularly with stemless and short-stemmed implants. The most frequent indications for primary implantation were osteoarthritis (34.6%), cuff tear arthropathy (27.8%), and proximal humerus fracture (23.6%). Among revision procedures, the most common causes were infection (31.6%) and instability (24.5%). Stemmed aTSA had the highest 1‑year revision risk (11.5%), whereas stemless aTSA and rTSA showed more favorable early survivorship (0.7%–2.1%).

Conclusion

The most frequently used implant type across indication groups was rTSA, accounting for 81% of primary procedures. Most primary procedures were performed for osteoarthritis, cuff tear arthropathy, or fractures. Revisions were mainly required for infection and instability, particularly in stemmed aTSA. Early cumulative revision rates remained low overall, with lower rates observed in stemless aTSA and rTSA.