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J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):903-6. doi: 10.1016/j.jse.2009.02.006. Epub 2009 May 22.

Shoulder arthroplasty in morbidly obese patients.

Author information

1
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.

Abstract

BACKGROUND:

The purpose of this study was to determine the results, complications, and failure rates of shoulder arthroplasty in morbidly obese patients.

METHODS:

Between 1994 and 2005, 45 shoulder arthroplasties were performed for osteoarthritis in patients with a BMI greater than 40. Forty-one shoulders were followed for a minimum of 2 years (mean, 55 months) or until revision.

RESULTS:

Shoulder arthroplasty in morbidly obese patients was associated with improvement in pain and range of motion (P </= .001). Average operative time was 220 minutes (range, 152-337). Four required anteromedial approaches. There was 1 intraoperative humeral shaft fracture and 2 small anterior deltoid avulsions. Five patients required overnight ICU monitoring. Average length of stay was 3.1 nights (range, 2-5). One shoulder developed a superficial infection while 1 patient had wound healing difficulty. Five shoulders underwent revision arthroplasty: 2 deep periprosthetic infections, 1 hemiarthroplasty for glenoid arthritis, 1 for posterior instability, and 1 for glenoid loosening. The Kaplan-Meier estimate for survival free of revision was 92.1% at 5 years.

CONCLUSIONS:

Shoulder arthroplasty in the morbidly obese is associated with long-term improvement in pain and function. However, the intraoperative and postoperative care of these patients is more complex, and these patients seem to have a higher rate of unsatisfactory results.

LEVEL OF EVIDENCE:

Level 4; Case series, treatment study.

PMID:
19464930
DOI:
10.1016/j.jse.2009.02.006
[Indexed for MEDLINE]

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