Acute complications after reverse total shoulder arthroplasty for treatment of cuff arthropathy versus fracture.

Abstract

Background: Reverse total shoulder arthroplasty (RTSA) has become increasingly popular in recent years, and this trend is expected to continue. However, differences in outcomes of RTSA for fractures compared with other indications are poorly understood. This study aimed to identify the compare the incidences of adverse events during RTSA to treat cuff tear arthropathy (CTA) versus RTSA to treat fractures, as well as identify risk factors for any adverse event.

Methods: Patients who underwent RTSA from 2010 to 2020 in the National Surgical Quality Improvement Program database were included. Matched cohorts were created using nearest-neighbor matching. Independent sample t-tests and chi-square tests were used to determine differences between groups, and binary logistic regression was performed to determine odds ratios and 95% CIs.

Results: In total, 27,607 CTA patients (94.5%) and 1,537 fracture patients (5.3%) underwent RTSA. Adverse events occurred in 1,088 CTA patients (3.9%) and 192 fracture patients (12.4%). Incidences of adverse events, postoperative transfusions, and returns to an operating room were all significantly higher in the fracture cohort compared with CTA patients.

Conclusions: Following surgery, higher rates of adverse events were observed in the CTA patients compared with those in the fracture cohort. These findings improve our understanding of the effectiveness of an increasingly popular surgical intervention due to the use of a large database analysis to identify short-term complications and risk factors. Level of evidence: III.