title: Complications rates, reoperation rates, and the learning curve in reverse shoulder arthroplasty.
abstract: BACKGROUND
  Reverse shoulder arthroplasty (RSA) has ushered a new era in shoulder surgery. However, the results of RSA also described the complication rates associated with the procedure as inordinate and a learning curve associated with the incidence of complications.
  
  
  METHODS
  The records of 112 patients who underwent 114 RSA procedures by the senior author (G.I.G.) were reviewed for complications related to a RSA. Of these, 93 RSA procedures were the primary treatment for the shoulder, and 21 were revisions.
  
  
  RESULTS
  The total complication rate for the entire group was 7%. Complications included 3 periprosthetic fractures, 3 hematomas, 1 acromion fracture, and 1 deep infection. The complication rate was 19% in the revision RSA group and 4.3% in the primary RSA group (P ≤ .02). Complication rates in the initial RSA patients in this series did not differ from the final procedures in this series (P = .96). The total reoperation rate was 5.3%, and was 19% in the revision RSA group vs 2.2% in the primary RSA group (P ≤ .02).
  
  
  CONCLUSIONS
  Complications and reoperations associated with a RSA, although significant, occurred at much lower rate than in previous reports. This series demonstrates a significant difference in complication rates and reoperation rates between primary and revision RSA. Revision RSA complications and reoperations were far more common than in primary RSA procedures. No evidence of a learning curve related to surgical experience was demonstrated in this series.
authors.affiliation: Blue Ridge Bone and Joint, Asheville, NC, USA. Electronic address: ggroh@brbj.com.
authors.forename: Gordon I
authors.initials: GI
authors.lastname: Groh
authors.affiliation: Blue Ridge Bone and Joint, Asheville, NC, USA.
authors.forename: Griffin M
authors.initials: GM
authors.lastname: Groh
mesh_terms: D000174:Acromion / Q000293:injuries / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000009:adverse effects* / Q000706:statistics & numerical data; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000706:statistics & numerical data; D019544:Equipment Failure Analysis; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D006811:Humerus / Q000293:injuries* / Q000601:surgery; D015994:Incidence; D022125:Lacerations / Q000601:surgery*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000453:epidemiology / Q000209:etiology; D012086:Reoperation; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D017211:Treatment Failure
keywords: Complication; infection; learning curve; periprosthetic fracture; reverse shoulder arthroplasty; scapular fracture; seroma