The effect of allergies on outcomes following shoulder arthroplasty: A national database analysis of 154,478 patients

Shoulder Elbow. 2024 Oct;16(5):527-533. doi: 10.1177/17585732231194615. Epub 2023 Aug 10.

Abstract

Background: The objective of this study is to investigate the effect of allergies on complications following total shoulder arthroplasty (TSA).

Materials and methods: All data were collected by using the PearlDiver national database to identify patients who had undergone TSA (anatomic or reverse) between 1 January 2010 and 31 October 2021. Patients were stratified into two groups: allergies and no allergies. Comparisons were made regarding complications and revision surgeries. Complications were compared at 30 and 90 days. Revisions were compared at 1, 5 and 10 years postoperatively.

Results: This study identified 28,182 patients with allergies and 126,296 patients without allergies. Patients with allergies were more likely to require revision surgery at all time points analyzed (p < 0.001). Patients with allergies were more likely to have sepsis within 30 (OR 1.53 [1.30-1.80], p < 0.001) and 90 days (1.71 [1.51-1.94], p < 0.001) postoperatively. Patients with allergies were more likely to experience a wound complication within 30 (1.89 [1.58-2.26], p < 0.001) and 90 days (1.81 [1.58-2.08], p < 0.001). The allergy group experienced higher rates of prosthetic joint infections (PJI) (2.14 [1.81-2.54], p < 0.001) and implant complications at 90 days (1.52 [1.42-1.62], p < 0.001).

Discussion: Patients with allergies were more likely to require revision surgery, experience wound complications, sepsis and PJI following TSA.

Keywords: allergies; national database; outcomes; revision surgery; total shoulder arthroplasty.