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J Shoulder Elbow Surg. 2014 Mar;23(3):388-94. doi: 10.1016/j.jse.2013.06.002. Epub 2013 Sep 8.

Complications rates, reoperation rates, and the learning curve in reverse shoulder arthroplasty.

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  • 1Blue Ridge Bone and Joint, Asheville, NC, USA. Electronic address:
  • 2Blue Ridge Bone and Joint, Asheville, NC, USA.



Reverse shoulder arthroplasty (RSA) has ushered a new era in shoulder surgery. However, the results of RSA also described the complication rates associated with the procedure as inordinate and a learning curve associated with the incidence of complications.


The records of 112 patients who underwent 114 RSA procedures by the senior author (G.I.G.) were reviewed for complications related to a RSA. Of these, 93 RSA procedures were the primary treatment for the shoulder, and 21 were revisions.


The total complication rate for the entire group was 7%. Complications included 3 periprosthetic fractures, 3 hematomas, 1 acromion fracture, and 1 deep infection. The complication rate was 19% in the revision RSA group and 4.3% in the primary RSA group (P ≤ .02). Complication rates in the initial RSA patients in this series did not differ from the final procedures in this series (P = .96). The total reoperation rate was 5.3%, and was 19% in the revision RSA group vs 2.2% in the primary RSA group (P ≤ .02).


Complications and reoperations associated with a RSA, although significant, occurred at much lower rate than in previous reports. This series demonstrates a significant difference in complication rates and reoperation rates between primary and revision RSA. Revision RSA complications and reoperations were far more common than in primary RSA procedures. No evidence of a learning curve related to surgical experience was demonstrated in this series.

Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.


Complication; infection; learning curve; periprosthetic fracture; reverse shoulder arthroplasty; scapular fracture; seroma

[PubMed - indexed for MEDLINE]
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