Neurologic complications of shoulder joint replacement

Area of Science:

• Orthopedic Surgery
• Neurology
• Patient Outcomes

Background:

• Neurologic complications following shoulder joint replacement (SJR) are underrecognized and can impede patient recovery.
• Previous literature has underestimated the incidence and impact of these nerve injuries.

Purpose of the Study:

• To determine the prevalence of nerve complications after SJR.
• To identify specific nerves affected and analyze patient outcomes.
• To understand the factors contributing to these complications.

Main Methods:

• A retrospective review of 211 SJRs in 202 patients over a 5-year period.
• Comprehensive analysis of postoperative nerve complications, including onset, duration, investigation, and treatment.
• Inclusion criteria focused on patients undergoing SJR with detailed follow-up.

Main Results:

• A 20.9% incidence of nerve complications was observed in 44 out of 211 SJRs.
• The median nerve (25 cases) and musculocutaneous nerve (8 cases) were most frequently involved.
• Reverse SJR procedures showed a higher association with nerve complications, predominantly affecting female patients.

Conclusions:

• Nerve complications after SJR are more common than previously thought, occurring in approximately 21% of cases.
• Most complications are transient neurapraxias, with the majority resolving within six months.
• Factors such as female sex, prior shoulder surgery, and direct nerve injury during glenoid exposure increase risk.