The risks for serious adverse events (SAEs) within 90 days of shoulder replacement surgery for arthritis are much higher than previously estimated, according to research published this week in the BMJ. The risk for SAE at 30 days post-surgery was 1 in 28 and at 90 days post-surgery was 1 in 22.
The population-based cohort study analysed data 58,054 elective shoulder replacements carried out on 51,895 adults aged ≥50 years between April 1998 and April 2017.
The lifetime risks for revision surgery ranged from 1 in 37 (2.7%; 95% CI, 2.6-2.8%) in women aged 85 years and older to 1 in 4 (23.6%; 95% CI, 23.2-24.0%) in men aged 55-59 years. The risks for revision were highest during the first 5 years after surgery.
The risk of any SAE within 30 days of surgery was 3.5% (95% CI, 3.4-3.7%), while the rate at 90 days post-surgery was 4.6% (95% CI, 4.4-4.8%).
The authors say younger patients, particularly men, need to be aware of the higher likelihood of early failure of shoulder replacement and the need for further and more complex revision replacement surgery.
They further advise that all patients should be counselled about the risks for SAE, which appear to be higher than previously thought and may outweigh the potential benefits of surgery in some patients.
“Our findings caution against unchecked expansion of shoulder replacement surgery in both younger and older patients,” they say.