Friday, September 13, 2013

reverse total shoulder: complications

Complications rates, reoperation rates, and the learning curve in reverse shoulder arthroplasty

This paper reports the experience of an individual surgeon with 114 reverse total shoulders (93 primary and 21 revisions). Patient age ranged from 53-86 (ave 64 yrs).  Indications were pseudoparalysis with massive cuff tear (73), severe proximal humeral fractures with osteopenia (20), failed hemiarthroplasty (14), failed total shoulder (4), failed internal fixation (3).

The total complication rate for the entire group was 7%. (19% in the revision group and 4.3% in the primary group). Complications included 3 periprosthetic fractures (typically at the distal end of the cement), 3 hematomas, 1 acromion fracture, and 1 deep infection.

A repeat operation was performed in 6 shoulders (5.3%):  2 open reduction and internal fixation procedures for type B periprosthetic humeral fractures, 2 irrigation and debridements, for postoperative hematomas, 1 irrigation and debridement with associated polyethylene and glenosphere exchange for deep infection.

The authors did not detect a learning curve effect in this series.


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