Skip to main content
SpringerLink
Log in

Early morbidity and mortality after one-stage bilateral shoulder arthroplasty

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract  

Purpose

One-stage bilateral shoulder arthroplasty has the advantage of requiring a single hospital stay and a single anaesthesia. The topic has been little reported, unlike one stage bilateral hip and knee arthroplasty, which have demonstrated their interest. The aim of the present study was to determine peri- and early post-operative morbidity and mortality after this procedure. The study hypothesis was that peri- and early post-operative morbidity and mortality in one stage bilateral shoulder arthroplasty is low in selected patients and that satisfaction is high.

Methods

A single-centre retrospective study assessed peri- and early post-operative morbidity and mortality in one stage bilateral shoulder arthroplasty. Twenty-one patients, aged < 80 years, with ASA score ≤ 3, were consecutively operated on between 1999 and 2020. Indications comprised primary osteoarthritis, aseptic osteonecrosis, inflammatory arthritis, massive rotator cuff tear, and dislocation fracture, involving both shoulders.

Results

There were no early deaths. The complication rate was 10% (4/21 cases). No prosthesis dislocation or sepsis was reported. Mean blood loss was 145 ± 40 cc, mean surgery time 164 ± 63 min, and mean hospital stay five ± four days. Only one patient required postoperative transfusion. Functional results at six months showed significantly improved range of motion and good patient satisfaction.

Conclusions

One-stage bilateral shoulder arthroplasty was feasible in selected patients. Mortality was zero, and morbidity was low. Surgery time was reasonable and required no repositioning. Postoperative home help is indispensable for patient satisfaction during rehabilitation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

Data are available on demand by contacting the corresponding author.

References 

  1. Wagner ER, Farley KX, Higgins I et al (2020) The incidence of shoulder arthroplasty: rise and future projections compared with hip and knee arthroplasty. J Shoulder Elbow Surg 29:2601–2609. https://doi.org/10.1016/j.jse.2020.03.049

    Article  PubMed  Google Scholar 

  2. Puzzitiello RN, Nwachukwu BU, Agarwalla A et al (2020) Patient satisfaction after total shoulder arthroplasty. Orthopedics 43:492–497. https://doi.org/10.3928/01477447-20200812-03

    Article  Google Scholar 

  3. Villatte G, Erivan R, Barth J et al (2020) Progression and projection for shoulder surgery in France, 2012–2070: epidemiologic study with trend and projection analysis. Orthop Traumatol Surg Res 106:1067–1077. https://doi.org/10.1016/j.otsr.2020.04.019

    Article  PubMed  Google Scholar 

  4. Fraser AN, Bjørdal J, Wagle TM et al (2020) Reverse shoulder arthroplasty is superior to plate fixation at 2 years for displaced proximal humeral fractures in the elderly: a multicenter randomized controlled trial. J Bone Joint Surg 102:477–485. https://doi.org/10.2106/JBJS.19.01071

    Article  PubMed  Google Scholar 

  5. Kobayashi T, Takagishi K, Yamamoto A et al (2012) The prevalence of shoulder osteoarthritis in middle and old age: association with risk factors and shoulder function. J Shoulder Elbow Surg 21:e28. https://doi.org/10.1016/j.jse.2012.10.016

    Article  Google Scholar 

  6. Yamaguchi K, Ditsios K, Middleton WD et al (2006) The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. JBJS 88:1699. https://doi.org/10.2106/JBJS.E.00835

    Article  Google Scholar 

  7. Dennis DA (2004) Debate: bilateral simultaneous total knee arthroplasty. Clin Orthop Relat Res 428:82–83. https://doi.org/10.1097/01.blo.0000147650.90507.84

    Article  Google Scholar 

  8. Leonard L, Williamson DM, Ivory JP, Jennison C (2003) An evaluation of the safety and efficacy of simultaneous bilateral total knee arthroplasty. J Arthroplasty 18:972–978. https://doi.org/10.1016/S0883-5403(03)00282-1

    Article  CAS  PubMed  Google Scholar 

  9. Macaulay W, Salvati EA, Sculco TP, Pellicci PM (2002) Single-stage bilateral total hip arthroplasty. J Am Acad Orthop Surg 10:217–221. https://doi.org/10.5435/00124635-200205000-00008

    Article  PubMed  Google Scholar 

  10. Micicoi G, de Dompsure RB, Micicoi L et al (2020) One-stage bilateral total hip arthroplasty versus unilateral total hip arthroplasty: a retrospective case-matched study. Orthop Traumatol Surg Res 106:577–581. https://doi.org/10.1016/j.otsr.2020.02.003

    Article  PubMed  Google Scholar 

  11. Gerber C, Lingenfelter EJ, Reischl N, Sukthankar A (2006) Single-stage bilateral total shoulder arthroplasty: A PRELIMINARY STUDY. J Bone Joint Surg Br 88–B:751–755. https://doi.org/10.1302/0301-620X.88B6.17601

  12. Feroussis JC, Papaspiliopoulos A, Kitsios E et al (2010) Single stage bilateral total shoulder arthroplasty. Orthop Proc  92–B:574–574. https://doi.org/10.1302/0301-620X.92BSUPP_IV.0920574

  13. Walters JD, Denard PJ, Brockmeier SF, Werner BC (2021) The relationship of bilateral shoulder arthroplasty timing and postoperative complications. J Shoulder Elbow Surg 30:317–323. https://doi.org/10.1016/j.jse.2020.06.010

    Article  PubMed  Google Scholar 

  14. Kunkel ST, Sabatino MJ, Kang R et al (2018) The cost-effectiveness of total hip arthroplasty in patients 80 years of age and older. J Arthroplasty 33:1359–1367. https://doi.org/10.1016/j.arth.2017.11.063

    Article  PubMed  Google Scholar 

  15. Azad A, Antonios JK, Kang HP, Omid R (2020) Single-stage bilateral reverse total shoulder arthroplasty for bilateral posterior shoulder fracture-dislocation following seizure: a case report. Int J Surg Case Rep 73:298–302. https://doi.org/10.1016/j.ijscr.2020.07.037

    Article  PubMed  PubMed Central  Google Scholar 

  16. White CB, Sperling JW, Cofield RH, Rowland CM (2003) Ninety-day mortality after shoulder arthroplasty. J Arthroplasty 18:886–888. https://doi.org/10.1016/S0883-5403(03)00269-9

    Article  PubMed  Google Scholar 

  17. Chalmers PN, Gupta AK, Rahman Z et al (2014) Predictors of early complications of total shoulder arthroplasty. J Arthroplasty 29:856–860. https://doi.org/10.1016/j.arth.2013.07.002

    Article  PubMed  Google Scholar 

  18. Chin PYK, Sperling JW, Cofield RH, Schleck C (2006) Complications of total shoulder arthroplasty: are they fewer or different? J Shoulder Elbow Surg 15:19–22. https://doi.org/10.1016/j.jse.2005.05.005

    Article  PubMed  Google Scholar 

  19. Dolci A, Melis B, Verona M et al (2021) Complications and intraoperative fractures in reverse shoulder arthroplasty: a systematic review. Geriatr Orthop Surg Rehabil 12:21514593211059864. https://doi.org/10.1177/21514593211059865

    Article  Google Scholar 

  20. Beazley J, Evans J, Furness N, Smith C (2018) Comparative learning curves for early complications in anatomical and reverse shoulder arthroplasty. Ann R Coll Surg Engl 100:491–496. https://doi.org/10.1308/rcsann.2018.0062

    Article  PubMed  PubMed Central  Google Scholar 

  21. Bohsali KI, Wirth MA, Rockwood CAJ (2006) Complications of total shoulder arthroplasty. JBJS 88:2279–2292. https://doi.org/10.2106/JBJS.F.00125

    Article  Google Scholar 

  22. Walch G, Bacle G, Lädermann A et al (2012) Do the indications, results, and complications of reverse shoulder arthroplasty change with surgeon’s experience? J Shoulder Elbow Surg 21:1470–1477. https://doi.org/10.1016/j.jse.2011.11.010

    Article  PubMed  Google Scholar 

  23. Gorman RA, Christmas KN, Simon P et al (2021) A cohort comparison of humeral implant designs in reverse shoulder arthroplasty: does implant design lead to lower rates of complications and revision? J Shoulder Elbow Surg 30:850–857. https://doi.org/10.1016/j.jse.2020.07.031

    Article  PubMed  Google Scholar 

  24. Florczynski M, Paul R, Leroux T, Baltzer H (2021) Prevention and treatment of nerve injuries in shoulder arthroplasty. JBJS 103:935–946. https://doi.org/10.2106/JBJS.20.01716

    Article  Google Scholar 

  25. Calkins TE, Mosher ZA, Throckmorton TW, Brolin TJ (2022) Safety and cost effectiveness of outpatient total shoulder arthroplasty: a systematic review. J Am Acad Orthop Surg 30:e233–e241. https://doi.org/10.5435/JAAOS-D-21-00562

    Article  PubMed  Google Scholar 

  26. Dunn JC, Lanzi J, Kusnezov N et al (2015) Predictors of length of stay after elective total shoulder arthroplasty in the United States. J Shoulder Elbow Surg 24:754–759. https://doi.org/10.1016/j.jse.2014.11.042

    Article  PubMed  Google Scholar 

  27. Hardy JC, Hung M, Snow BJ et al (2013) Blood transfusion associated with shoulder arthroplasty. J Shoulder Elbow Surg 22:233–239. https://doi.org/10.1016/j.jse.2012.04.013

    Article  PubMed  Google Scholar 

  28. Friedman RJ, Gordon E, Butler RB et al (2016) Tranexamic acid decreases blood loss after total shoulder arthroplasty. J Shoulder Elbow Surg 25:614–618. https://doi.org/10.1016/j.jse.2015.09.014

    Article  PubMed  Google Scholar 

  29. Abildgaard JT, McLemore R, Hattrup SJ (2016) Tranexamic acid decreases blood loss in total shoulder arthroplasty and reverse total shoulder arthroplasty. J Shoulder Elbow Surg 25:1643–1648. https://doi.org/10.1016/j.jse.2016.02.002

    Article  PubMed  Google Scholar 

  30. Dacombe P, Kendall J, McCann P et al (2019) Blood transfusion rates following shoulder arthroplasty in a high volume UK centre and analysis of risk factors associated with transfusion. Should Elb 11:67–72. https://doi.org/10.1177/1758573218774317

    Article  CAS  Google Scholar 

  31. Levy JC, Everding NG, Gil CC et al (2014) Speed of recovery after shoulder arthroplasty: a comparison of reverse and anatomic total shoulder arthroplasty. J Shoulder Elbow Surg 23:1872–1881. https://doi.org/10.1016/j.jse.2014.04.014

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Military Teaching Hospital, 34 Boulevard Laveran, 13384, Marseille, France

    Bernard de Geofroy, Nicolas Bronsard, Jean-François Gonzalez & Marc Olivier Gauci

  2. Department of Orthopaedic Surgery and Sport Surgery, University Institute of Locomotion and Sport, University Hospital of Nice, 30 Av Voie Romaine, 06000 Cedex 1, Nice, CS, France

    Grégoire Micicoi & Manuel Olmos

  3. Institut de Chirurgie Réparatrice, Groupe Kantys, Locomoteur & Sport, Clinique St Antoine7 Av Durante, 06000, Nice, France

    Pascal Boileau

Authors
  1. Bernard de Geofroy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Grégoire Micicoi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manuel Olmos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pascal Boileau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nicolas Bronsard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jean-François Gonzalez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marc Olivier Gauci
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: B de Geoffroy, MO Gauci, P Boileau. Data curation: B de Geoffroy, M Olmos, P Boileau. Formal analysis: B de Geoffroy, M Olmos. Funding acquisition: none. Investigation: B de Geoffroy. Methodology: MO Gauci. Project administration: JF Gonzalez, N Bronsard. Resources: JF Gonzalez. Software: none. Supervision: MO Gauci. Validation: MO Gauci. Visualization: B de Geoffroy, MO Gauci. Writing — original draft: B de Geoffroy, G Micicoi. Writing — review and editing: MO Gauci. All authors approved the final manuscript.

Corresponding author

Correspondence to Marc Olivier Gauci.

Ethics declarations

Ethics approval

Institutional review board approval was obtained for this study: IRB_IULS2021_004.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare that they have no ties of interest in this study. Apart from this work, MO Gauci is a consultant for Stryker; P. Boileau is a consultant and receives royalties from Stryker, Smith & Nephew, and Conmed; JF Gonzalez is a consultant for Symbios. The other authors declare no relevant financial or non-financial interests to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Level of evidence: IV

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Geofroy, B., Micicoi, G., Olmos, M. et al. Early morbidity and mortality after one-stage bilateral shoulder arthroplasty. International Orthopaedics (SICOT) 48, 505–511 (2024). https://doi.org/10.1007/s00264-023-06003-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-023-06003-5

Keywords

Search

Navigation