Clinical and radiographic predictors of difficult primary shoulder arthroplasty

• Published in: Seminars in arthroplasty 2022-03, Vol.32 (1), p.63-73
• Main Authors: Hendy, Benjamin A., Parmar, Jason, Kohan, Eitan M., Rogalski, Brandon L., Ramsey, Matthew L., Abboud, Joseph A., Williams, Gerald R., Namdari, Surena, Lazarus, Mark D.
• Format: Article
• Language: English
• Subjects: Anatomic Shoulder Arthroplasty; Difficult; Easy; Predict; Primary Shoulder Arthroplasty; Reverse Shoulder Arthroplasty; Technical complexity
• ISSN: 1045-4527; 1558-4437
• DOI: 10.1053/j.sart.2021.06.006

Anecdotally there is a spectrum of complexity in performing shoulder arthroplasty, however, there is limited information to predict easy versus difficult cases. The purpose of this study was to identify clinical and radiographic factors that are associated with difficult primary shoulder arthroplasty. All consecutive primary shoulder arthroplasties performed by one-of-five high-volume shoulder and elbow fellowship-trained surgeons from 4/2018-8/2018 were included. Mean (range) surgeon years in practice was 19.4 (6-29). Surgeons completed a preoperative questionnaire estimating the level of complexity in performing the operation from very easy, easy, average, difficult, and very difficult. The same questionnaire was completed immediately postoperatively regarding level of complexity. Difficult group was defined if the surgeon rated as difficult or very difficult on the postoperative questionnaire. If the procedure was difficult, the postoperative questionnaire assessed what aspect of the procedure made it difficult. Demographics, clinical and radiographic factors, and procedure time were collected. During the study period, 224 primary shoulder arthroplasties were performed (53% reverse, 44% anatomic, 3% hemiarthroplasty with concentric glenoid reaming). Difficult group consisted of 95 shoulder arthroplasties (42.4%). Difficult group procedure time was a mean 21.8 minutes longer (120.7 ± 3.1 min vs. 98.9 ± 2.4 min; P