Risk Factors and Complications for Revision Shoulder Arthroplasty

Abstract

Background

Revision shoulder arthroplasty has become increasingly common as primary arthroplasty has become more widespread.

Questions/Purposes

We sought to answer two questions: What are the risks factors for revision shoulder arthroplasty? What are the complications associated with revision shoulder arthroplasty?

Methods

A retrospective search of a national insurance database from the years 2013 to 2016 was undertaken for billing codes of patients undergoing revision shoulder arthroplasty. The odds ratios for revision of various patient demographic characteristics and comorbidities were determined. The incidences of various complications within 90 days of revision were determined.

Results

A total of 824 cases of revision shoulder arthroplasty were found. Eighty-seven patients (10.5%) had infections prior to revision and 133 patients (16.1%) had dislocations prior to revision. Of the risk factors examined, smoking status was associated with the highest odds ratio for revision (8.1). Additionally, depression, Charlson Comorbidity Index (CCI), male gender, renal failure, and diabetes were significant risks factors for revision. The most common complication of revision shoulder arthroplasty was found to be surgical site infection, affecting 10.9% of patients. In the time period studied, 89 patients underwent more than one revision shoulder arthroplasty.

Conclusion

Despite limitations inherent in database studies, this data may have utility for surgeons in pre-operative counseling of patients on their risk.

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Change history

  • 01 May 2019

    The name of author Anirudh K. Gowd was listed incorrectly in the original article. It is corrected here.

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Correspondence to Natalie L. Leong MD.

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Conflict of Interest

Natalie L. Leong, MD, Shelby Sumner, MPH, and Ani Gowd, BS, declare that they have no conflicts of interest. Anthony A. Romeo, MD, reports personal fees from AANA and MLB; grants and personal fees from Arthrex; grants from Aesculap/B. Braun, Histogenics, Medipost, NuTech, OrthoSpace, Smith & Nephew, and Zimmer; royalties and personal fees from Saunders/Mosby-Elsevier; board membership, royalties, and financial support from SLACK Incorporated; board membership in AOSSM, ASES, Atreon Orthopaedics, Orthopedics Today, SAGE, and Wolters Kluwer Health-Lippincott Williams & Wilkins, outside the submitted work. Gregory P. Nicholson, MD, reports personal fees from Tornier, Innomed, Arthrosurface, and Wright Medical, and board membership from American Shoulder and Elbow Society, outside the submitted work. Nikhil N. Verma, MD, reports personal fees from MLB; grants from OrthoSpace, Mitek, Arthrex, Arthrosurface, Inc, DJ Orthopedics, Ossur, Athletico, ConMed Linvatec, and Miomed; publishing royalties and editorial board membership from Arthroscopy; stock or stock options from Cymedica and Omeros; stock or stock options and personal fees from Minivasive; grants, personal fees, and royalties from Smith & Nephew; personal fees and publishing royalties from Vindico Medical-Orthopedics Hyperguide; board membership in Arthroscopy Association Learning Center Committee, AOSSM, ASES, Journal of Knee Surgery, and SLACK Incorporated, all outside the submitted work.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.

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Informed consent was waived from all patients for being included in this study.

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Level of Evidence: Level IV: prognostic, retrospective study

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Leong, N.L., Sumner, S., Gowd, A. et al. Risk Factors and Complications for Revision Shoulder Arthroplasty. HSS Jrnl 16, 9–14 (2020). https://doi.org/10.1007/s11420-019-09673-3

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Keywords

  • revision shoulder arthroplasty
  • database study
  • complication rate
  • risk factors
  • demographic trends
  • comorbidities