Complications of total shoulder-replacement arthroplasty.

Abstract

Complications associated with orthopaedic prostheses or implants account for approximately 5 per cent of the more than 3.5 million hospitalizations for musculoskeletal conditions82. This is important in light of the increasing number of patients who receive prostheses and the fact that the average age of patients who have a total shoulder arthroplasty is the lowest among those for all major joint replacements28,73. Like replacement procedures in other major joints, total shoulder arthroplasty is associated with numerous complications, including prosthetic loosening, glenohumeral instability, tears of the rotator cuff, periprosthetic fracture, infection, neural injury, and dysfunction of the deltoid. In recent years, mirroring the increase in the number of total joint arthroplasties in general, the number of shoulder-replacement procedures has increased substantially28,71-73. However, despite this growth, fewer than 5000 total shoulder replacements were performed annually in the United States from 1990 through 1992, compared with 136,000 total hip and total knee arthroplasties28,71-73. Although the short-term (less than two-year) and mid-term (two to five-year) results of total shoulder arthroplasties have been encouraging, with some authors reporting good and excellent results in more than 90 per cent of shoulders, widespread experience and long-term evaluations approaching those for joint replacements in the lower extremities have not been published1,5,6,13,23,44,53,64,65,78. Our review of forty-one series involving 1858 total shoulder arthroplasties reported from 1975 through 1995 revealed an average duration of follow-up of only 3.5 years3-6,12,13,15,16,19,25,26,32,34,38,40-42,44,48,53, …