Implant-related and medical complications in patients with sarcopenia undergoing total shoulder arthroplasty: A retrospective matched-cohort analysis

Abstract

Background In the continually aging United States population, the number of patients with sarcopenia who undergo shoulder arthroplasty may concomitantly increase. This retrospective cohort study aims to evaluate the rates of short-term implant-related and medical complications following shoulder arthroplasty in patients with and without a recent diagnosis of sarcopenia. Methods An exact 1:3 matched analysis of 4177 patients was performed using the PearlDiver database. Multivariable logistic regression was used to compare complications, Kaplan–Meier failure analysis was used to compare the cumulative hospital readmission rates. Two-sample T-testing was used to compare the 90-day cost of care. Results Sarcopenic patients were significantly more likely to experience postoperative shoulder instability (odds ratio (OR) = 2.32, 95% confidence interval (CI), 1.21−4.39) and periprosthetic infection (OR = 3.83, 95% CI, 1.74–8.67) within 1 year of their arthroplasty. Sarcopenic patients were at 25% and 41% greater risk of emergency department presentation and hospital readmission 1-year post-arthroplasty, respectively. Ninty-day total costs were greater among sarcopenics ($16 112.23 vs. 10 679.58, p < 0.001). Conclusion These results are important for orthopaedic surgeons counselling patients with a low muscle mass on the potential for increased complications after undergoing a total shoulder arthroplasty procedure.