Comparison of patient demographics and patient-related risk factors for dislocations following reverse shoulder arthroplasty

Abstract

Abstract Introduction : Dislocations following primary reverse total shoulder arthroplasty (rTSA) are a feared and concerning complication. With the increasing number of reverse total shoulder arthroplasty (rTSA) procedures being performed worldwide e, studies evaluating risk factors for dislocation following this procedure are limited. The purpose of this study was to utilize a large claims database to identify patient-related risk factors associated with dislocations following primary rTSA. Methods : A retrospective query of the Part A and Part B 100% Medicare Standard Analytical Files (SAF) claims database was performed identifying patients who underwent primary rTSA for the treatment of glenohumeral osteoarthritis. The inclusion criteria for the study group consisted of all patients who had a dislocation within 2-years following the index procedure. Patients with a record of other arthroplasty-type procedures were excluded. The query yielded 30,670 patients with (n\u202f=\u202f703) and without (n\u202f=\u202f29,967) dislocations. Multivariate binomial logistics regression analysis was performed to calculate odds (OR) on the impact of patient-related risk factors for dislocations following primary rTSA. A p-value less than 0.002 was considered statistically significant. Results : Study group patients that sustained a dislocation following primary rTSA were generally younger than the age of 65 (16.8 vs. 8.3%) and male (59.6 vs. 38.8%). Study group patients had a higher comorbidity burden, as demonstrated by higher mean Elixhauser-Comorbidity Index (ECI) scores (9 vs. 6, p Conclusion : As the number of primary rTSA procedures increase worldwide, identification of patient-related risk factors for dislocations is of great importance. The study showed the greatest risk factors for dislocations included male sex with modifiable risk factors being opioid use disorder, hypertension, and morbid obesity. The study is vital as it can facilitate in guiding orthopedists and altering management for these high-risk patients. Level of evidence : Level III