Shoulder arthroplasty in morbidly obese patients.

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.

• Authors: Christopher J Linberg, John W Sperling, Cathy D Schleck, Robert H Cofield
• Journal: Journal of shoulder and elbow surgery (J Shoulder Elbow Surg) 2009 Nov-Dec Vol. 18 Issue 6 Pg. 903-6 ISSN: 1532-6500 [Electronic] United States
• PMID: 19464930 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Arthroplasty, Replacement (adverse effects)
• Female
• Humans
• Male
• Middle Aged
• Obesity, Morbid (complications)
• Osteoarthritis (complications, surgery)
• Postoperative Complications (epidemiology)
• Shoulder Joint (surgery)
• Treatment Failure