Epidemiology of revision shoulder arthroplasty in the United States: incidence, demographics, and projected volume from 2018 to 2030

Matthew J. Best, Kevin Y. Wang, Suresh K. Nayar, Amil R. Agarwal, Edward G. McFarland, Uma Srikumaran

Research output: Contribution to journalArticlepeer-review


Background: Thorough understanding of surgical indications and type of revision shoulder arthroplasty (SA) performed aids policy making decisions, resource allocation, and research into cost and utilization. The purpose of this study was to determine indications for and the type of revision SA performed in the United States. Methods: Healthcare Cost and Utilization Project National Inpatient Sample database was used to analyze clinical, demographic, and economic data from 61,615 revision SA procedures performed from 2012 to 2018. The prevalence of revision procedures was calculated for population subgroups in the United States that were stratified according to age, sex, diagnosis, primary payer class, and type of hospital using the most recent year of data. The indication for revision and average length of stay after revision surgery were also determined for each type of revision arthroplasty procedure. Linear regression was used to estimate procedures through 2030, using incidence values from 2012 to 2018. Results: Annual volume of revision SA in the United States increased by 153% from 5650 procedures in 2012 to 14,300 procedures in 2018. Linear regression predicted a continued increase in this annual volume, increasing to 37,329 revision SA procedures by 2030. The most common SA procedure performed in the revision setting was reverse shoulder arthroplasty and the most common indications for revision were for instability (25%) and infection (21%). Revision SA procedures were most commonly performed in patients aged 60-70 years, with a mean age of 66.6 years and with Medicare insurance (66%). The mean length of hospital stay for revision SA was 3.1 days. Conclusion: Annual volume of revision SA increased by 153% from 2012 to 2018 in the United States with a continued predicted increase through 2030. Instability and infection are the most common indications for surgery. Reverse shoulder arthroplasty was the most commonly performed surgery in the revision setting.

Original languageEnglish (US)
Pages (from-to)53-58
Number of pages6
JournalSeminars in Arthroplasty
Issue number1
StatePublished - Mar 2023


  • Epidemiology
  • Incidence
  • Incidence trends
  • Level IV
  • Projected volume
  • Retrospective Epidemiology Study (Large Database Analysis)
  • Revision shoulder arthroplasty
  • Shoulder arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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