Surgical Complications After Reverse Total Shoulder Arthroplasty and Total Shoulder Arthroplasty in the United States

Introduction: Shoulder arthroplasty has become popular in the treatment of degenerative shoulder conditions in the United States. Shoulder arthroplasty usage has expanded to younger patients with increased surgical indications. Methods: Reverse total shoulder arthroplasty (RTSA) and TSA patient records with the 1-year follow-up between 2015 and 2018 were queried from the nationwide PearlDiver Mariner Shoulder Database using International Classification of Disease-10 codes. Chi-square analysis was done to compare the demographics, surgical complications, and revision procedures between RTSA and TSA. Results: From 2010 to 2018, there was an increase in shoulder arthroplasty cases because of RTSA. The overall surgical complication and revision procedure rates were 2.26% and 3.56% for RTSA, and 6.36% and 2.42% for TSA. Patients older than 50 years had statistically lower surgical complications after RTSA than TSA (2.25% versus 3.94%, P < 0.05), whereas no statistical difference between RTSA and TSA for patients younger than 50 years (10.06% versus 7.45%, P = 0.19). Male patients had higher RTSA complication rates (3.12% versus 2.28%, P < 0.05), whereas female patients had higher TSA (4.86% versus 5.92%, P < 0.05). History of tobacco, depression, and obesity were risk factors for higher complications. Conclusion: RTSA has become more commonly done than TSA in the United States. Older patients who underwent shoulder arthroplasty had lower surgical complication. TSA had a higher surgical complication rate than RTSA for patients older than 50 years.