Inflammatory bowel disease is associated with increased postoperative complications following shoulder arthroplasty: a propensity-matched analysis

Introduction: Shoulder arthroplasty (SA) is one of the most common joint replacement surgeries performed and its utilization continues to rise. Inflammatory Bowel Disease (IBD) is associated with decreased bone mineral density and increased risk of fractures. However, the literature remains divided whether IBD contributes to a heightened risk of postoperative complications. This study examines the potential impact of IBD on the incidence of postoperative infections following shoulder arthroplasty. Methods: We analyzed data from the PearlDiver Mariner 165 database from January 1, 2010, to October 31, 2022. Patients who underwent total or reverse shoulder arthroplasty were identified and categorized into two groups, those with IBD and those without, using a 1:5 propensity score-matching approach. Matching was based on demographic data and infection-related comorbidities. Surgical site infections (SSIs) and hospital readmissions were measured at 90-days postoperatively. Surgical complications, including need for revision surgery, prosthetic joint infection (PJI), instability, and aseptic loosening, were recorded up to 2-years following the procedure. Chi-square tests and multivariate logistic regression using odds ratio analysis were performed, with the significance level (α) set at 0.05. Results: The cohort comprised 5,647 IBD patients and 28,177 propensity-matched non-IBD controls, with comparable demographic and comorbidity profiles. There was a statistically significant increase in 90-day readmissions and 2-year SSIs among IBD patients. Similarly, 2-year postsurgical complications, including SSI, PJI, and aseptic loosening, were greater in the IBD group. Conclusion: IBD is a significant risk factor for increased postoperative infection rates in shoulder arthroplasty patients. Although readmission rates are similar at the 2-year mark, along with other post-op complications, further study is needed to understand how medical treatment for IBD can impact the infection rates on SA.