Low complication rate following reverse total shoulder arthroplasty at 90-days follow-up - A systematic review

Louise M Kent; Eoghan T Hurley; Martin S Davey; Christopher S Klifto; Hannan Mullett

doi:10.1016/j.jisako.2023.11.006

Low complication rate following reverse total shoulder arthroplasty at 90-days follow-up - A systematic review

J ISAKOS. 2024 Apr;9(2):205-210. doi: 10.1016/j.jisako.2023.11.006. Epub 2023 Nov 16.

Authors

Louise M Kent¹, Eoghan T Hurley², Martin S Davey¹, Christopher S Klifto¹, Hannan Mullett¹

Affiliations

¹ Sports Surgery Clinic, Dublin D09 C523, Ireland; Duke University Hospital, Durham, NC 27710, USA.
² Sports Surgery Clinic, Dublin D09 C523, Ireland; Duke University Hospital, Durham, NC 27710, USA. Electronic address: eoghan.hurley@duke.edu.

PMID: 37979691
DOI: 10.1016/j.jisako.2023.11.006

Abstract

Importance: As reverse total shoulder arthroplasty (RTSA) has become an increasingly common procedure, rates of post-operative complications leading to potential hospital readmission are of greater importance. No previous systematic reviews have focused exclusively on post-operative complications and mortality rates at 90 days post RTSA.

Objectives: The purpose of this study was to review complication, readmission, and mortality rates within 90 days post RTSA.

Evidence review: Two independent reviewers performed a literature search using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines using PubMed, Embase, and Web of Science databases. Only studies reporting on outcomes of RTSA at 90-days follow-up specifically were considered for inclusion.

Findings: Our search included 79,037 shoulders (62.1 % female) from a total of 15 studies with an average age of 72.4 ± 5.8 years. The overall 90-day re-admission rates were reported in nine studies as 6.1 % (4205/69,127) following RTSA. Additionally, a total of five studies reported the overall 90-day mortality rate as 1.1 % (19/1733). The overall pooled rate of medical complications was 3.9 % (2998/77,826) as reported in 13 studies, at 90-days post-RTSA, with the occurrence of anaemia being the most commonly reported outcomes as 2.9 % (1013/34,385) in six studies. The overall rate of surgical complications was 1.1 % reported in 13 studies (1327/77,826), with the pooled rate of surgical revisions of 1.5 % (607/40,563) at 90-days follow-up. A total of 8, 5, and 3 studies reported rates of dislocation, requirement for closed reduction and glenoid loosening as 0.9 % (344/37,995), 0.6 % (7/1180), and 0.3 % (30/9115) respectively at 90-days following RTSA.

Conclusions and relevance: This study established that the overall rates of mortality and medical and surgical complications are low in the short-term following RTSA, with only 6 % of patients requiring re-admission in the first 90 days.

Level of evidence: IV - Systematic Review of all levels of evidence.

Keywords: 90-Day; Complication; Mortality; RSA; RTSA; Readmission; Reverse total shoulder arthroplasty.

Publication types

Systematic Review
Review

MeSH terms

Aged
Arthroplasty, Replacement, Shoulder* / adverse effects
Arthroplasty, Replacement, Shoulder* / methods
Female
Follow-Up Studies
Humans
Male
Postoperative Complications / epidemiology
Scapula