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.
BACKGROUND: The purpose of this study was to determine the results, complications, and failure rates of shoulder arthroplasty in morbidly obesepatients. 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 obesepatients 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: Bradley S Schoch; William R Aibinder; Jean-David Werthel; John W Sperling; Joaquin Sanchez-Sotelo; Robert H Cofield Journal: Int Orthop Date: 2017-08-07 Impact factor: 3.075
Authors: Jimmy J Jiang; Jason R Somogyi; Pranay B Patel; Jason L Koh; Douglas R Dirschl; Lewis L Shi Journal: Clin Orthop Relat Res Date: 2015-10-09 Impact factor: 4.176
Authors: Richard J Friedman; Josef Eichinger; Bradley Schoch; Thomas Wright; Joseph Zuckerman; Pierre-Henri Flurin; Charlotte Bolch; Chris Roche Journal: JSES Open Access Date: 2019-11-18