Bohsali and colleagues reviewed total shoulder arthroplasty series published from 1996 to 2005 to see whether follow‑up had lengthened and whether the frequency and types of complications had changed.
Current Concepts Review pooling 39 studies and 2,810 total shoulder replacements, minimum 2‑year follow‑up.
Methods
Design
Current Concepts Review
Pooled analysis of published series
Included
39 studies
2,810 total shoulder replacements
Minimum 2‑year follow‑up
Only 3 series (190 shoulders) with 10+ years of follow‑up
Population
2,540 unconstrained shoulders for complication‑specific rates
5 reverse prosthesis series (261 shoulders)
Outcomes
Overall complication rate
Type of each complication
Key Findings
Complications occurred at a rate of 14.7%, with 414 events reported across 2,810 total shoulder replacements.
Component loosening was the leading complication (161 of 414, 39%), and 134 of those 161 cases (83%) involved the glenoid.
In series with at least 10 years of mean follow‑up, glenoid radiolucent lines were reported in nearly 80% of 148 shoulders and radiographic loosening in 50 (34%), but only 11 (7%) were revised for glenoid loosening.
Instability was the second most common complication (124 of 414, 30%), and superior instability was the leading type (77), ahead of posterior (25) and anterior (22).
The axillary nerve accounted for 13 of 20 neural injuries, and 10 of the 13 resolved without surgery.
Across 5 reverse prosthesis series (261 shoulders, mean follow‑up 3.1 years), motion and pain improved but complication rates were high (mean 24.4%, range 6.25% to 50%).
Board pearl
Postoperative rotator cuff tears affected 1.3% of 2,540 unconstrained shoulders (32 cases), and the subscapularis was the torn tendon in 17 of them (53%).
Authors' conclusion
Glenoid component loosening has continued to be an unresolved problem.
Bohsali and colleagues reviewed total shoulder arthroplasty series published from 1996 to 2005 to see whether follow‑up had lengthened and whether the frequency and types of complications had changed.
Current Concepts Review pooling 39 studies and 2,810 total shoulder replacements, minimum 2‑year follow‑up.
Methods
Design
Current Concepts Review
Pooled analysis of published series
Included
39 studies
2,810 total shoulder replacements
Minimum 2‑year follow‑up
Only 3 series (190 shoulders) with 10+ years of follow‑up
Population
2,540 unconstrained shoulders for complication‑specific rates
5 reverse prosthesis series (261 shoulders)
Outcomes
Overall complication rate
Type of each complication
Key Findings
Complications occurred at a rate of 14.7%, with 414 events reported across 2,810 total shoulder replacements.
Component loosening was the leading complication (161 of 414, 39%), and 134 of those 161 cases (83%) involved the glenoid.
In series with at least 10 years of mean follow‑up, glenoid radiolucent lines were reported in nearly 80% of 148 shoulders and radiographic loosening in 50 (34%), but only 11 (7%) were revised for glenoid loosening.
Instability was the second most common complication (124 of 414, 30%), and superior instability was the leading type (77), ahead of posterior (25) and anterior (22).
The axillary nerve accounted for 13 of 20 neural injuries, and 10 of the 13 resolved without surgery.
Across 5 reverse prosthesis series (261 shoulders, mean follow‑up 3.1 years), motion and pain improved but complication rates were high (mean 24.4%, range 6.25% to 50%).
Board pearl
Postoperative rotator cuff tears affected 1.3% of 2,540 unconstrained shoulders (32 cases), and the subscapularis was the torn tendon in 17 of them (53%).
Authors' conclusion
Glenoid component loosening has continued to be an unresolved problem.