Early revision within 1 year after shoulder arthroplasty: patient factors and etiology

Abstract

Background: The objective of this study is to investigate the patient factors associated with early revision within 1 year after shoulder arthroplasty, including total shoulder arthroplasty (TSA), hemiarthroplasty, and reverse TSA, and the cause of failure leading to early revision.

Methods: Patients who underwent shoulder arthroplasty from 2005 to 2012 were identified using International Classification of Diseases, Ninth Revision procedure codes. Those who underwent revision shoulder arthroplasty were then divided into early (<1 year) and late (>1 year) groups. Patients in each of the cohorts were queried for demographic data and etiologic factors for revision arthroplasty.

Results: A total of 221,381 patients who underwent shoulder arthroplasty were identified, including 115,956 TSAs, 75,208 hemiarthroplasties, and 30,217 reverse TSAs. The patient factors significantly associated with early revision after shoulder arthroplasty regardless of type were age younger than 65 years, smoking, obesity, and morbid obesity. Dislocation was the most common reason for early revision after all types of arthroplasties. Loosening was a more common reason for early revision after TSA compared with both hemiarthroplasty and reverse TSA.

Conclusions: Several patient factors appear to be associated with early revision after shoulder arthroplasty, including younger age, smoking, obesity, and male sex. The cause of failure leading to early revision varies between late and early revision cases. These findings are important to identify patients preoperatively who may be at risk of early revision after shoulder arthroplasty to allow appropriate patient counseling and risk stratification.

Keywords: Total shoulder arthroplasty; complications; early revision arthroplasty; etiology; reverse total shoulder arthroplasty; risk factors; shoulder hemiarthroplasty.