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A comparison of perioperative outcomes in patients with and without rheumatoid arthritis after receiving a total shoulder replacement arthroplasty.

Publication ,  Journal Article
Hambright, D; Henderson, RA; Cook, C; Worrell, T; Moorman, CT; Bolognesi, MP
Published in: J Shoulder Elbow Surg
January 2011

HYPOTHESIS: The long-term survival rate of total shoulder arthroplasty (TSA) is comparable to hip and knee arthroplasty. Although TSA is considered a safe and effective procedure with low complications in patients with osteoarthritis and rheumatoid arthritis (RA), data are lacking on perioperative complications. Complication rates and hospital disposition differences between patients with and without RA who underwent TSA were investigated. We hypothesized that RA patients would have poorer perioperative outcomes after TSA. MATERIALS AND METHODS: Data from the Nationwide Inpatient Sample was used to capture 25,398 patients between 1988 and 2005 who underwent TSA. Of these, 1,186 patients had a primary diagnosis of RA and were compared with 24,212 patients without RA. Analyses addressed perioperative complications and hospital disposition factors using bivariate and logistic regression models. RESULTS: Overall complication rates were exceptionally low in both groups. Hospital disposition factors were significantly different between the 2 groups. The RA cohort had shorter average lengths of stay, higher likelihood of routine discharge, and lower inflation-adjusted cost before and after adjustment for covariates. DISCUSSION: The occurrence of complications in the perioperative setting was less than 1% for both study groups in most variables investigated, and there were only minimal differences in perioperative complications between the groups. The significant differences in hospital disposition factors suggest that patients with RA may have less complex hospital stays and may be more comfortable being discharged under their own care. Recent studies describing the overall improvement in the management of patients with RA may also help explain these findings. CONCLUSIONS: The findings suggest that the perioperative complications of a total shoulder replacement for patients with and without RA are similar. Contrary to our expectations, TSA patients with RA had shorter and less costly hospital stays and were more likely to have routine discharge. Complications are likely more long-term in nature than detected in this study and require longer follow-up beyond perioperative periods for fruition.

Duke Scholars

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

January 2011

Volume

20

Issue

1

Start / End Page

77 / 85

Location

United States

Related Subject Headings

  • Shoulder Joint
  • Orthopedics
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Health Care Costs
  • Female
  • Arthroplasty, Replacement
  • Arthritis, Rheumatoid
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hambright, D., Henderson, R. A., Cook, C., Worrell, T., Moorman, C. T., & Bolognesi, M. P. (2011). A comparison of perioperative outcomes in patients with and without rheumatoid arthritis after receiving a total shoulder replacement arthroplasty. J Shoulder Elbow Surg, 20(1), 77–85. https://doi.org/10.1016/j.jse.2010.03.005
Hambright, Dustin, Robert A. Henderson, Chad Cook, Ted Worrell, Claude T. Moorman, and Michael P. Bolognesi. “A comparison of perioperative outcomes in patients with and without rheumatoid arthritis after receiving a total shoulder replacement arthroplasty.J Shoulder Elbow Surg 20, no. 1 (January 2011): 77–85. https://doi.org/10.1016/j.jse.2010.03.005.
Hambright D, Henderson RA, Cook C, Worrell T, Moorman CT, Bolognesi MP. A comparison of perioperative outcomes in patients with and without rheumatoid arthritis after receiving a total shoulder replacement arthroplasty. J Shoulder Elbow Surg. 2011 Jan;20(1):77–85.
Hambright, Dustin, et al. “A comparison of perioperative outcomes in patients with and without rheumatoid arthritis after receiving a total shoulder replacement arthroplasty.J Shoulder Elbow Surg, vol. 20, no. 1, Jan. 2011, pp. 77–85. Pubmed, doi:10.1016/j.jse.2010.03.005.
Hambright D, Henderson RA, Cook C, Worrell T, Moorman CT, Bolognesi MP. A comparison of perioperative outcomes in patients with and without rheumatoid arthritis after receiving a total shoulder replacement arthroplasty. J Shoulder Elbow Surg. 2011 Jan;20(1):77–85.
Journal cover image

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

January 2011

Volume

20

Issue

1

Start / End Page

77 / 85

Location

United States

Related Subject Headings

  • Shoulder Joint
  • Orthopedics
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Health Care Costs
  • Female
  • Arthroplasty, Replacement
  • Arthritis, Rheumatoid