title: 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.
  
  
  METHODS
  Level 4; Case series, treatment study.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Linberg
authors.forename: John W
authors.initials: JW
authors.lastname: Sperling
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Schleck
authors.forename: Robert H
authors.initials: RH
authors.lastname: Cofield
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D010003:Osteoarthritis / Q000150:complications* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012785:Shoulder Joint / Q000601:surgery*; D017211:Treatment Failure