Comparison of Complication Types and Rates Associated with Anatomic and Reverse Total Shoulder Arthroplasty
These authors sought to the determine the types, incidence and timing of complications following 2224 aTSAs (1090M/1134F) and 4158 rTSAs (1478M/2680F) from an international database of patients who had a single platform total shoulder arthroplasty system (Equinoxe, Exactech) performed by 40 different surgeons in the US/Europe. Patients with revision of a previously placed hemiarthroplasty or total shoulder arthroplasty, or a diagnosis of proximal humerus fracture were excluded.
Of the 2224 aTSA patients, 239 adverse events were reported for a complication rate of 10.7% and
124 revisions for a revision rate of 5.6%. The top three complications for aTSA were rotator cuff tear/subscapularis failure (n=69, complication rate=3.1%, revision rate=1.9%), aseptic glenoid
loosening (n=55, complication rate=2.5%, revision rate=1.9%) and infection (n=28, complication
rate=1.3%, revision rate=0.8%)
Of the 4158 rTSA patients, 372 adverse events were reported for a complication rate of 8.9% and 104 revisions for a revision rate of 2.5%. The top three complications for rTSA were acromial/scapular fracture/pain (n=102, complication rate=2.5%, revision rate=0.0%), instability (n=60, complication rate=1.4%, revision rate=1.0%) and pain (n=49, complication 23 rate=1.2%, revision rate=0.2%).
Comment: This is a comprehensive review of the complications reported with these prostheses for a very large patient cohort from an international group of surgeons.
This is a valuable guide for surgeons using this implant so that they can be aware of and seek to avoid the complications most frequent with each prosthesis type.
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