Shoulder Hemiarthroplasty Is Associated With Higher 30-Day Complication Rates Compared With Total Shoulder Arthroplasty for Glenohumeral Osteoarthritis: A Propensity Score Matched Analysis

Abstract

Background: Anatomical total shoulder arthroplasty (TSA) and shoulder hemiarthroplasty (HA) have both been shown to have good outcomes in patients with osteoarthritis of the glenohumeral joint. However, evidence comparing perioperative complications between these procedures in this population is heterogeneous. Materials and Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried between the years 2012 and 2021 (10 years in total) for records of patients who underwent either TSA or HA for osteoarthritis of the glenohumeral joint. Patients in each group underwent a 1:1 propensity match for demographic variables. Bivariate and multivariate analyses were performed to compare complications and risk factors between these cohorts. Results: A total of 4376 propensity-matched patients, with 2188 receiving TSA and 2188 receiving HA, were included in the primary analyses. The HA cohort had a higher rate of any adverse event (7.18% vs 4.8%, P =.001), death (0.69% vs 0.1%, P =.004), sepsis (0.46% vs 0.1%, P =.043), postoperative transfusion (4.62% vs 2.2%, P <.001), postoperative intubation (0.5% vs 0.1%, P =.026), and extended length of stay (23.77% vs 13.1%, P <.001). HA was found to increase the odds of developing these complications when baseline demographics were controlled. Older age (odds ratio, 1.040; 95% CI, 1.021-1.059; P <.001) and lower body mass index (odds ratio, 0.949; 95% CI, 0.923-0.975; P <.001) increased the odds of having any adverse event in the HA cohort but not in the TSA cohort. Conclusion: Compared with TSA, HA appears to be associated with significantly higher rates of 30-day postoperative complications when performed for glenohumeral osteoarthritis. [ Orthopedics . 2024;47(4):217-224.]