Obesity is Not Associated with Increased Short-term Complications After Primary Total Shoulder Arthroplasty

Jiang, Jiaren; Somogyi, Jason R.; Patel, Pranay B.; Koh, Jason L.; Dirschl, Douglas R.; Shi, Lewis L.

doi:10.1007/s11999-015-4584-3

Cited by 55 publications

(30 citation statements)

References 29 publications

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“…High BMI increases the surgical complexity and risk for complications out to 6 months (Beck et al 2013; Griffin et al 2014; Gupta et al 2014; Werner et al 2015a, b), but may not impact 30-day complications (Jiang et al 2016). Obesity does not necessarily inhibit gains in outcome scores and quality of life (QOL) over the short-term (Li et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients

Vincent¹,

Struk

Reed

et al. 2016

SpringerPlus

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BackgroundShoulder pain and loss of function are directly associated with obesity.Questions/purposesWe hypothesized that significant interactions would exist between total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RSA) and obesity status on functional and quality of life (QOL) outcomes over the long term. Clinical and QOL outcomes (American Shoulder and Elbow Surgeons Evaluation form, Shoulder Pain and Disability Index, University of California at Los Angeles Shoulder Rating scale, Medical Outcomes Short Form 12 (SF-12), range of motion (ROM), and strength) were longitudinally compared in patients with low and high body mass index (BMI) after a TSA or a RSA. Prospectively collected data of patients with a TSA or RSA were reviewed (N = 310). Preoperative, 2-year, and final follow-up visits were included (range 3–17 years; mean 5.0 ± 2.5 years). Patient data were stratified for analysis using BMI.ResultsMorbidly obese patients had worse preoperative functional scores and QOL compared to the other groups. There were no significant interactions of BMI group by surgery type for any of the outcome variables except for active external rotation ROM. Morbidly obese patients attained lower SF-12 scores compared to the remaining groups at each time point.ConclusionsBoth TSA and RSA can be expected to impart positive functional outcomes in patients irrespective of BMI. Morbidly obese patients do not attain the same gains in Medical Outcomes SF-12 scores as the non-morbidly obese patients. The lower improvements in active external ROM may be due to morphological limitations of excessive adiposity.Level of evidenceThis is a level II study.

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Section: Introductionmentioning

confidence: 99%

Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients

Vincent¹,

Struk

Reed

et al. 2016

SpringerPlus

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“…Total shoulder arthroplasty (TSA) is an excellent operation to address pain relief and to provide functional improvement for patients limited by glenohumeral arthritis who have failed to respond to conservative measures 18 . The number of TSAs performed in the United States is growing rapidly,9, 17 and patient demand is increasing substantially in the last 4 decades, with an average increase in volume of TSA of 9.4% per year 1, 9.…”

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confidence: 99%

Safety and patient satisfaction of outpatient shoulder arthroplasty

et al. 2018

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BackgroundThere is increasing interest in outpatient shoulder arthroplasty (SA); however, the clinical evidence behind this practice is sparse. The purpose of this study was to assess the safety of outpatient SA performed in an ambulatory surgery center and to determine patient factors that are associated with increased risk for perioperative complications or dissatisfaction.MethodsPatient demographics and operative variables were collected retrospectively for patients undergoing outpatient SA at 2 ambulatory surgery centers with a minimum follow-up of 90 days. Patients completed a postsurgery questionnaire about their experience, satisfaction, pain control, and health care use.ResultsForty-one anatomic total SAs (n = 32) and reverse SAs (n = 9) with a mean follow-up of 60 weeks (16.4 weeks-3 years) were included. The mean age, body mass index, Charlson Comorbidity Index, and American Society of Anesthesiologists class were 60.6 ± 4.8 years, 31.8 ± 6.6, 2.9 ± 1.9, and 2.3 ± 0.6, respectively. Three (7.3%) minor complications occurred within 90 days of the SA, none before first follow-up. Two patients stayed in the ambulatory surgery center 23-hour observation unit. Thirty-five patients (85.4%) completed the questionnaire, of whom 97.0% (n = 32) were satisfied with the outpatient procedure. Two patients had difficulties with postoperative pain control and were taking chronic narcotic medication before surgery.ConclusionOutpatient SA in an ambulatory surgery center is safe with high patient satisfaction and low rates of perioperative complications. Although larger cohorts are required to adequately determine which patients will be appropriate candidates for an outpatient SA, our findings do suggest that patients with a history of preoperative narcotic use may have difficulties or dissatisfaction with outpatient SA.

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“…While a negative association between obesity and outcomes has been well-established after total hip and knee arthroplasty, 1,10,13,21 the correlation is far less obvious after total shoulder arthroplasty. 7,11,24 …”

Section: Discussionmentioning

confidence: 99%

Shoulder Arthroplasty Outcomes in Patients With Multiple Reported Drug Allergies

Rosenthal

Knesek

Kahlenberg

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:The presence of multiple allergies has been correlated with worse outcomes for patients undergoing hip and knee arthroplasty, but the effect of allergies has not yet been elucidated with respect to shoulder arthroplasty.Purpose/Hypothesis:The purpose of this study is to identify any discrepancies in shoulder arthroplasty outcomes with respect to reported drug allergies. We hypothesized that patients with multiple drug allergies would have inferior outcomes.Study Design:Cohort study; Level of evidence, 3.Methods:Included in the analysis were a single surgeon’s cases between 2009 and 2014 of primary total shoulder arthroplasty with a minimum of 180 days of follow-up. Cases with fracture as the indication were excluded. Preoperative and postoperative metrics included visual analog scale (VAS) for pain, forward flexion range of motion, and Simple Shoulder Test (SST) results, and postoperative patient satisfaction scores were also collected. Chi-square and 1-way analysis of variance with Tukey post hoc analyses were performed when appropriate.Results:A total of 98 patients were included (no allergies, n = 51; single allergy, n = 21; multiple allergies, n = 26). The proportion of females was greater with increasing number of allergies (no allergies, 31%; single allergies, 47%; multiple allergies, 88%; Pearson χ2 = 22.5; P < .0001). Both preoperatively and postoperatively, no difference was found between cohorts with respect to SST score, VAS score, or forward flexion. There was also no difference in postoperative satisfaction between cohorts. No difference between cohorts was identified when comparing the pre- to postoperative change in SST scores, VAS scores, or forward flexion.Conclusion:The presence of single or multiple allergies is not correlated with worse outcomes after primary anatomic total shoulder arthroplasty.

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Obesity is Not Associated with Increased Short-term Complications After Primary Total Shoulder Arthroplasty

Cited by 55 publications

References 29 publications

Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients

Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients

Safety and patient satisfaction of outpatient shoulder arthroplasty

Shoulder Arthroplasty Outcomes in Patients With Multiple Reported Drug Allergies

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