Analysis on revision rates of shoulder arthroplasty at a single referral center in Canada

Abstract

BackgroundThe aim of the present report is to study a historic cohort on revision rates and indications from our local shoulder arthroplasty registry over the last 16 years. MethodsAn overall population of 1545 in the period of 2005 and 2021 was analyzed, identifying 149 shoulder arthroplasty revisions, from which 26.1% were resurfacing hemiarthroplasty, 40.9% stemmed hemiarthroplasty, 14% total shoulder arthroplasty (TSA), and 18.7% reverse shoulder arthroplasty (RSA). ResultsThe overall revision rate identified in our population was 7.7% (n = 149/1545). This was distributed between stemmed hemiarthroplasty with a revision rate of 14.2% (n = 61/428), 13.4% (n = 39/291) for resurfacing hemiarthroplasty, 8.6% (n = 28/324) for RSA, and 4.2% (n = 21/497) for TSA. Glenoid erosion was the main revision indication in 38.9% of the cases, followed by aseptic loosening in 19.46% and instability in 15.44%. Only 12 cases (8.05%) were revised due to infection and 2 of those required two-staged procedure. The most common implant type used in revisions was RSA with 41.61% followed by TSA in 34.23% of the cases. Thirty patients (20.1%) required more than one revision procedure and 43% (n = 13/30) of them were revised to RSA. Acute fracture (adjusted odds ratio = 2.67, 95% confidence interval 1.66-4.29; P < .01) and avascular necrosis (adjusted odds ratio = 2.18, 95% confidence interval 1.03-4.63; P .043) were associated with an increased risk of revision surgery. DiscussionThe main implants revised were stemmed and unstemmed hemiarthroplasties. RSA was the most frequent implant used for revisions.