title: Intraoperative complications during revision shoulder arthroplasty: a study using the National Joint Registry dataset.
abstract: BACKGROUND
  The surgical options for revision shoulder arthroplasty and the number of procedures performed are increasing. However, little is known about the risk factors for intraoperative complications associated with this complex surgery.
  
  
  METHODS
  The National Joint Registry (NJR) is a surgeon reported database recording information on major joint replacements including revision shoulder arthroplasty. Using multivariable binary logistic regression modelling, we analyzed 1445 revision shoulder arthroplasties reported to the NJR between April 2012 and 2015.
  
  
  RESULTS
  The risk of developing a complication during revision surgery was greater than primary arthroplasty (5% versus 2.5%). An intraoperative fracture was the most common complication occurring in 50 (3.5%) cases. Nerve injuries were recorded for two (0.1%) patients and vascular injuries for one (0.1%) patient. The incidence of intraoperative fractures was higher in females than males (relative risk = 3.25;p= 0.005). Periprosthetic fracture as an indication for revision carried the highest risk for any complication (relative risk = 3.00,p= 0.06).
  
  
  CONCLUSIONS
  This is the largest registry study to date investigating the incidence and risk factors for intraoperative complications during revision shoulder arthroplasty. Females have over three times the risk of intraoperative fractures compared to males. This study will help inform surgeons to accurately counsel patients.
authors.affiliation: Department of Orthopaedics and Trauma, James Cook University Hospital, Middlesbrough,UK.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Ingoe
authors.affiliation: Department of Orthopaedics and Trauma, James Cook University Hospital, Middlesbrough,UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Holland
authors.affiliation: Department of Orthopaedics and Trauma, James Cook University Hospital, Middlesbrough,UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Cowling
authors.affiliation: Department of Orthopaedics and Trauma, James Cook University Hospital, Middlesbrough,UK.
authors.forename: Lucksy
authors.initials: L
authors.lastname: Kottam
authors.affiliation: Department of Orthopaedics and Trauma, James Cook University Hospital, Middlesbrough,UK.
authors.forename: Paul N
authors.initials: PN
authors.lastname: Baker
authors.affiliation: Department of Orthopaedics and Trauma, James Cook University Hospital, Middlesbrough,UK.
authors.forename: Amar
authors.initials: A
authors.lastname: Rangan
keywords: National Joint Registry; complication; fracture; neurovascular injury; revision; shoulder arthroplasty