Do Patient-reported Allergies Lead to Poor Outcomes Following Shoulder Arthroplasty? A Systematic Review

Abstract

AbstractTotal shoulder arthroplasty (TSA) is growing more widespread, with over 100,000 TSA cases each year in the USA. Previous research shows increasing number of patient-reported allergies is associated with worse surgical outcomes following orthopedic procedures. This study systematically reviewed the association of patient-reported allergies to outcomes following TSA. A comprehensive review of the PubMed, EBSCO host, Medline, and Google Scholar electronic databases was conducted identifying all studies reporting on the association of patient-reported allergies to TSA outcomes between January 1, 2000 and June 1, 2022. The following keywords and MeSH terms were utilized in combination with “AND” or “OR” Boolean operators: “shoulder arthroplasty,” “shoulder replacement,” “allergy,” “allergies,” and “hypersensitivity.” The final analysis included 8 studies with a total of 166,303 patients. Four studies looked at all types of allergies, 2 studies looked at drug allergies, and 2 studies looked at antibiotic allergies. Of the 8 articles included in the study, 6 reported having more reported allergies is associated with worse outcomes. Patients in the better outcome group reported an average of 1.6 allergies, while those in the worse outcome group reported an average of 3.3 allergies. Patients with more reported antibiotic allergies are at a higher risk of PJIs. Furthermore, patients with more reported allergies were at an increased risk of pain intensity, length of stay (LOS), and worse patient-reported outcomes. In conclusion, a higher number of patient reported allergies is associated with worse outcomes following TSA. Although patient-reported allergies may not always be accurate, they could still serve as a preliminary screening tool to identify patients who require further diagnostic testing to confirm the presence of allergies.