Serious complications associated with shoulder surgery are low, but one in 26 patients needs further surgery within a year, according to a study published today.
Research led by Oxford University, UK, used NHS hospital data for England to estimate the risks of complications within 90 days of the most common elective shoulder arthroscopy procedures, and reoperation within one year.
Between 1 April 2009 and 31 March 2017, 288,250 arthroscopic shoulder procedures were performed in 261,248 patients who were aged 16 years and over.
The rate of complications within 90 days following arthroscopic shoulder surgery, including reoperation, was 1.2%, with one in 81 patients at risk.
Complications include: death, pulmonary embolism, pneumonia, heart attack, acute kidney injury, stroke, and urinary tract infection, and reoperations within one year.
The most common adverse event was pneumonia at one in 303 patients at risk, while pulmonary embolism was rare at one in 1,428 patients.
One in 26 patients underwent reoperation within one year, and reoperation due to infection was low at one in 1,111 patients but was higher for rotator cuff repair at one in 526 patients.
They found high reoperation rates after frozen shoulder release surgery, which, say the researchers, highlights the poorly understood and unpredictable nature of the condition.
Although this is an observational study, the researchers say their results are based on a large sample of population level data.
“The findings of this study suggest that risks of serious adverse events associated with common shoulder arthroscopy procedures are low,” write the researchers.
“Nevertheless, serious complications do occur, and include the risk of reoperation in one in 26 patients within one year.
“As the numbers of other arthroscopic shoulder procedures continue to increase, this study provides real world generalisable estimates of serious adverse events and reoperation rates that should better inform surgeons and patients.”
Rees JL, Craig R, Nagra N et al. Serious adverse event rates and reoperation after arthroscopic shoulder surgery: population based cohort study. BMJ 7 July 2022; doi: 10.1136/bmj-2021-069901
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