Arthroscopic Shoulder Surgery Results in Reoperation for 1-in-26 Patients Within One Year: Study

Researchers say the new data on arthroscopic shoulder surgery reoperations will help surgeons and patients better understand the risks of complications.

The findings of a new study suggest that almost 4% of individuals undergoing arthroscopic shoulder surgery experience problems that result in the need for an additional operation within a year.

While the overall rates of complications are relatively low, with only about 1.2% of patients experiencing complications within about 30 days, researchers warn that about one out of every 26 patients require reoperation within a year, according to a study published this month in the medical journal The BMJ.

Oxford Researchers used data from the Hospital Episode Statistics for NHS England, including civil registration mortality data from the Office for National Statistics, compiling information on 288,250 arthroscopic shoulder surgeries performed on 261,248 patients from April 2009 to March 2017.

Elective procedures were grouped into subacromial decompression, rotator cuff repair, acromioclavicular joint excision, glenohumeral stabilization, and frozen shoulder release.

The overall complication rate 90 days after arthroscopic shoulder surgery was roughly one in 81 patients. However, the specific complication rate varied according to the type of surgery. The complication rate was 0.6% for glenohumeral stabilization surgery and 1.7% for frozen shoulder release surgery.

Glenohumeral stabilization surgery is a surgical procedure used to treat chronic instability of the shoulder joint. Frozen shoulder release focuses on reducing pain and improving range of motion in the shoulder.

The most frequent complication reported was pneumonia, with one in 303 patients at risk. About 0.1% of patients, or one in 1,428, suffered pulmonary embolic events, or blood clots to the lungs. Other types of complications include heart attack, acute kidney injury, stroke, urinary tract infections, and in some cases death.

Despite low complication rates, at one year post-surgery, researchers found that the reoperation rate was 3.8%. Specific complication rates for reoperation were 2.7% for glenohumeral stabilization surgery and 5.7% for frozen shoulder release.

The need for additionally surgery due to infection was low, affecting 0.1% of patients, or putting 1-in-1,111 patients at risk. The highest rate of infection was among those undergoing rotator cuff surgery affecting 0.2% of those having that surgery, or 1-in-526 patents at risk, but still a low rate of infection

Over the course of the study period, the number of arthroscopic shoulder procedures increased, except for subacromial decompression surgeries, which decreased. Researchers said the study data helps to offer information on side effects and the need for reoperation to help better inform surgeons and patents of the risks. Yet, overall complications rates are low, but the need for follow-up surgery is higher.

“The findings of this study suggest that risks of serious adverse events associated with common shoulder arthroscopy procedures are low,” the researchers concluded. “Nevertheless, serious complications do occur, and include the risk of reoperation in one in 26 patients within one year.”