Choosing the best shoulder replacement

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 earliest.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 shoulder. The implant design can be anatomical, where the ball and socket are replaced (which has been the conventional treatment for many years); or reverse, where the orientation of the …