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New analyses fill an important evidence gap while we wait for trials
In 2020, the National Institute for Health and Care Research commissioned the randomised RAPSODI trial, aiming to find the best type of joint replacement for the treatment of painful osteoarthritis of the shoulder. This trial commenced in 2022, but will not report its results until the spring of 2027 at the eaanatorliest.1 In a linked paper in The BMJ (doi:10.1136/bmj-2023-077939), Valsamis and colleagues leveraged routinely collected data from public and private hospitals in England, using modern epidemiological methods to provide faster high quality evidence to answer this important question.2 By combining data from the National Joint Registry and NHS Hospital Episode Statistics datasets, they harnessed one of the world’s largest and most comprehensive repositories of shoulder replacement information.
Joint replacement is an effective treatment for pain and reduced function caused by osteoarthritis of the should
Jonathant-evansChristopherd-smithJonathanp-evansNational-institute-for-healthCare-researchNational-joint-registryNational-instituteEpisode-statisticsObjectives To answer a national research priority by comparing the risk-benefit and costs associated with reverse total shoulder replacement (RTSR) and anatomical total shoulder replacement (TSR) in patients having elective primary shoulder replacement for osteoarthritis.
Design Population based cohort study using data from the National Joint Registry and Hospital Episode Statistics for England.
Setting Public hospitals and publicly funded procedures at private hospitals in England, 2012-20.
Participants Adults aged 60 years or older who underwent RTSR or TSR for osteoarthritis with intact rotator cuff tendons. Patients were identified from the National Joint Registry and linked to NHS Hospital Episode Statistics and civil registration mortality data. Propensity score matching and inverse probability of treatment weighting were used to balance the study groups.
Main outcome measures The main outcome measure was revision surgery. Secondary outcome measures included serious adverse e
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