Reverse shoulder arthroplasty has a higher risk of revision due to infection than anatomical shoulder arthroplasty

Abstract

Aims The aim of this study was to use national registry database information to estimate cumulative rates and relative risk of revision due to infection after reverse shoulder arthroplasty. Patients and Methods We included 17 730 primary shoulder arthroplasties recorded between 2004 and 2013 in The Nordic Arthroplasty Register Association (NARA) data set. With the Kaplan–Meier method, we illustrated the ten-year cumulative rates of revision due to infection and with the Cox regression model, we reported the hazard ratios as a measure of the relative risk of revision due to infection. Results In all, 188 revisions were reported due to infection during a mean follow-up of three years and nine months. The ten-year cumulative rate of revision due to infection was 1.4% overall, but 3.1% for reverse shoulder arthroplasties and 8.0% for reverse shoulder arthroplasties in men. Reverse shoulder arthroplasties were associated with an increased risk of revision due to infection also when adjusted for sex, age, primary diagnosis, and year of surgery (relative risk 2.41 (95% confidence interval 1.26 to 5.59); p = 0.001). Conclusion The overall incidence of revision due to infection was low. The increased risk in reverse shoulder arthroplasty must be borne in mind, especially when offering it to men. Cite this article: Bone Joint J 2019;101-B:702–707.

Anatomic total shoulder arthroplasty for primary glenohumeral osteoarthritis is associated with excellent outcomes and low revision rates in the elderly

“…11,20 Some authors have also found a higher rate of deep infection in patients undergoing RSA when compared with TSA. 16,21 In addition, restoration of motion seems to be superior with anatomic TSA, especially in terms of internal rotation.…”

Analysis of revision shoulder arthroplasty in the German nationwide registry from 2014 to 2018

“…Moeini et al 11 report about a 10-year cumulative revision rate for reverse arthroplasties of 8% as a result of the analysis of n = 17730 arthroplasties in the Nordic Arthroplasty Register Association from Denmark, Norway, and Sweden. Based on the same registry, Lehtimäki et al 10 report about a moderate midterm risk of revision of RSAs of 5% with infection being the most common reason for revision.…”

A review of registry research from 2019

“…The first of these articles looked at a comparison of short term (six year) survival between stemmed and stemless shoulder arthroplasty with the second article comparing infection rates between reverse shoulder replacement (RSR) and hemiarthroplasty. 11,12 The population in Rasmussen et al's article in the Journal of Shoulder and Elbow surgery 12 was patients with osteoarthritis (OA) who underwent shoulder replacement between 2011 and 2016 in Denmark, Finland, Norway or Sweden. The intervention was stemless shoulder replacement and comparator was the more frequently implanted stemmed shoulder replacement.…”