Sunday, November 13, 2016

Total shoulder and reverse total shoulder complications - how often and what?

Complication rate and implant survival for reverse shoulder arthroplasty versus total shoulder arthroplasty: results during the initial 2 years.

These authors identified all patients undergoing reverse total shoulder (RTSA) or total shoulder arthroplasty (TSA) from 2011 to 2013 in a statewide database.

 10,844 procedures (6,658 TSA; 4,186 RTSA) were found. 

The all-cause complication rate at 90 days and 2 years postoperatively was significantly higher for RTSA (P < .001). 
RTSA patients had a significantly increased risk of infection (P < .05) and dislocation (P < .001) in the early and midterm postoperative course. 
Workers' compensation, male sex, preoperative anemia, and those aged younger than 65 years had a significantly higher risk for complications (P < .001). 

The overall complication rates for TSA and RSA were 8.4 and 9.9 percent at one year and 14.3 and 21.8 percent at two years.

 Risk factors for complications for RSA were male sex, workers compensation insurance, age under 65 years, anemia and workers compensation and age under 65 for TSA

Comment: The rates of complications depend on many factors in addition to those identified here, such as diagnosis, surgeon experience, and the type of prosthesis used. However, this study gives a nice overall view of the practice in California.

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