Risk factors for complication requiring reintervention following reverse shoulder arthroplasty: a retrospective study 2011–2021

Abstract

Background: Degenerative disease of the shoulder is successfully managed with arthroplasty. In the presence of a deficient rotator cuff, the non-anatomic reverse shoulder arthroplasty (RSA) is advantageous. High rates of complication following RSA have been reported in previous international investigations. We aimed to determine the local complication requiring reintervention rate, and identify any associated risk factors.

Methods: We conducted a retrospective electronic medical record review of all patients that underwent RSA between January 2011 and December 2021. Basic demographic details including type and number of comorbidities were captured, and follow-up notes reviewed for the documentation of complications. The data was summarised, the complication requiring reintervention rate calculated, and logistic regression performed to identify any factors associated with an increased risk of complication.

Results: A total of 93 patients met inclusion criteria, including six patients with bilateral pathology accounting for 99 cases, with a median follow-up of 1 121 days. The cohort comprised predominantly female patients (65%) with a median age of 72 years, and 55% required RSA for rotator cuff arthropathy. A total of 24% of cases complicated and required reintervention; 20% required additional surgery. Ten cases complicated with sepsis, 12 cases with instability, and one each with a haematoma and mechanical failure. Ninety-three per cent of patients had comorbid disease, and renal pathology was associated with a 5.9 times increased risk of complication.

Conclusion: In a ten-year review of patients undergoing RSA for degenerative disease, we report a 24% complication requiring reintervention rate. The most common complications included instability and sepsis. Patients with renal pathology were found to be at greater risk of complications requiring reintervention. Future prospective evaluation of RSA outcomes is needed to identify all factors contributary to complications.

Level of evidence: 4