Tags

Type your tag names separated by a space and hit enter

Reverse shoulder arthroplasty has higher perioperative implant complications and transfusion rates than total shoulder arthroplasty.
JSES Open Access. 2019 Jul; 3(2):108-112.JO

Abstract

Background

Indications for reverse total shoulder arthroplasty (RTSA) have expanded. The purpose of this retrospective cohort study was to evaluate national trends in shoulder arthroplasty utilization and to compare national perioperative complication rates for hemiarthroplasty (HA), total shoulder arthroplasty (TSA), and RTSA in a matched cohort.

Methods

The National Inpatient Sample was queried from 2011-2013 to identify patients who underwent HA, TSA, or RTSA. Age, sex, race, insurance type, Elixhauser comorbidity index, and perioperative complications were identified. A coarsened exact matching algorithm was used to match RTSA patients with TSA and HA patients to compare medical and implant-related perioperative in-hospital complications. Multivariable logistic regression analysis was performed on unmatched data to identify risk factors for development of perioperative complications.

Results

Overall, 42,832 shoulder arthroplasties were identified (44% TSAs, 34% RTSAs, 19% HAs). After matching, RTSAs had 6.2 times the odds of a perioperative implant-related complication (P < .001) and 2 times the odds of a red blood cell transfusion compared with TSAs (P < .001). The logistic regression model showed that prior shoulder arthroplasty (odds ratio [OR], 15.1; P < .001), younger age (OR, 0.98; P = .006), earlier year of index surgery (OR, 0.83; P = .002), history of illicit drug use (OR, 6.2; P = .008), and depression (OR, 2.3; P = .003) were risk factors for development of in-hospital implant-related complications after RTSA.

Conclusion

The perioperative implant-related complication rate and postoperative transfusion rate of RTSAs were significantly higher than those of TSAs. In addition, prior shoulder surgery, younger age, earlier year of index surgery, history of illicit drug use, and depression were risk factors for implant-related complications after RTSA. However, the perioperative RTSA implant-related complications did decline each year, suggesting a growing national proficiency with performing RTSA.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, MA, USA.Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, MA, USA.Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, MA, USA.Department of Orthopaedics, New England Baptist Hospital, Boston, MA, USA.Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA.Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31334437

Citation

Botros, Mina, et al. "Reverse Shoulder Arthroplasty Has Higher Perioperative Implant Complications and Transfusion Rates Than Total Shoulder Arthroplasty." JSES Open Access, vol. 3, no. 2, 2019, pp. 108-112.
Botros M, Curry EJ, Yin J, et al. Reverse shoulder arthroplasty has higher perioperative implant complications and transfusion rates than total shoulder arthroplasty. JSES Open Access. 2019;3(2):108-112.
Botros, M., Curry, E. J., Yin, J., Jawa, A., Eichinger, J. K., & Li, X. (2019). Reverse shoulder arthroplasty has higher perioperative implant complications and transfusion rates than total shoulder arthroplasty. JSES Open Access, 3(2), 108-112. https://doi.org/10.1016/j.jses.2019.03.001
Botros M, et al. Reverse Shoulder Arthroplasty Has Higher Perioperative Implant Complications and Transfusion Rates Than Total Shoulder Arthroplasty. JSES Open Access. 2019;3(2):108-112. PubMed PMID: 31334437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reverse shoulder arthroplasty has higher perioperative implant complications and transfusion rates than total shoulder arthroplasty. AU - Botros,Mina, AU - Curry,Emily J, AU - Yin,Jonathan, AU - Jawa,Andrew, AU - Eichinger,Josef K, AU - Li,Xinning, Y1 - 2019/06/14/ PY - 2019/7/24/entrez PY - 2019/7/25/pubmed PY - 2019/7/25/medline KW - Total shoulder arthroplasty KW - in-hospital complications KW - national shoulder implant utilization KW - perioperative complications KW - perioperative implant complications KW - reverse total shoulder arthroplasty SP - 108 EP - 112 JF - JSES open access JO - JSES Open Access VL - 3 IS - 2 N2 - Background: Indications for reverse total shoulder arthroplasty (RTSA) have expanded. The purpose of this retrospective cohort study was to evaluate national trends in shoulder arthroplasty utilization and to compare national perioperative complication rates for hemiarthroplasty (HA), total shoulder arthroplasty (TSA), and RTSA in a matched cohort. Methods: The National Inpatient Sample was queried from 2011-2013 to identify patients who underwent HA, TSA, or RTSA. Age, sex, race, insurance type, Elixhauser comorbidity index, and perioperative complications were identified. A coarsened exact matching algorithm was used to match RTSA patients with TSA and HA patients to compare medical and implant-related perioperative in-hospital complications. Multivariable logistic regression analysis was performed on unmatched data to identify risk factors for development of perioperative complications. Results: Overall, 42,832 shoulder arthroplasties were identified (44% TSAs, 34% RTSAs, 19% HAs). After matching, RTSAs had 6.2 times the odds of a perioperative implant-related complication (P < .001) and 2 times the odds of a red blood cell transfusion compared with TSAs (P < .001). The logistic regression model showed that prior shoulder arthroplasty (odds ratio [OR], 15.1; P < .001), younger age (OR, 0.98; P = .006), earlier year of index surgery (OR, 0.83; P = .002), history of illicit drug use (OR, 6.2; P = .008), and depression (OR, 2.3; P = .003) were risk factors for development of in-hospital implant-related complications after RTSA. Conclusion: The perioperative implant-related complication rate and postoperative transfusion rate of RTSAs were significantly higher than those of TSAs. In addition, prior shoulder surgery, younger age, earlier year of index surgery, history of illicit drug use, and depression were risk factors for implant-related complications after RTSA. However, the perioperative RTSA implant-related complications did decline each year, suggesting a growing national proficiency with performing RTSA. SN - 2468-6026 UR - https://www.unboundmedicine.com/medline/citation/31334437/Reverse_shoulder_arthroplasty_has_higher_perioperative_implant_complications_and_transfusion_rates_than_total_shoulder_arthroplasty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2468-6026(19)30009-9 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.