Complications of Shoulder Arthroplasty

Update This article was updated on May 17, 2017, because of a previous error. On page 256, the sentence that had read “The current analysis revealed a total of 19,262 TSAs and RSAs at a mean follow-up of 40.3 months in 122 studies, with an overall complication rate of 7.4% (2,122 complications) 3-124 ” now reads “The current analysis revealed a total of 19,262 TSAs and RSAs at a mean follow-up of 40.3 months in 122 studies, with an overall complication rate of 11% (2,122 complications) 3-124 .” An erratum has been published: J Bone Joint Surg Am. 2017 June 21;99(12):e67. The most common complications after reverse shoulder arthroplasty in order of decreasing frequency included instability, periprosthetic fracture, infection, component loosening, neural injury, acromial and/or scapular spine fracture, hematoma, deltoid injury, rotator cuff tear, and venous thromboembolism (VTE). The most common complications after anatomic total shoulder arthroplasty (TSA) in order of decreasing frequency were component loosening, glenoid wear, instability, rotator cuff tear, periprosthetic fracture, neural injury, infection, hematoma, deltoid injury, and VTE. Glenoid component wear and loosening remain a common cause of failure after anatomic TSA, despite advances in surgical technique and implant design. Diagnostic confirmation of infection after shoulder arthroplasty remains a challenge. In the setting of a painful and stiff shoulder after arthroplasty, the surgeon should have a heightened suspicion for infection. Inflammatory markers may be normal, radiographs may be inconclusive, and prosthetic joint aspiration may be negative for a causative organism.