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

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.

Duke Scholars

Author Christopher Scott Klifto Orthopaedic Surgery