Effects of Rheumatoid Arthritis on Postoperative Complications and Hospitalization Outcomes After Reverse Shoulder Arthroplasty: Insights from 389,135 Inpatient Cases in a National Database

By
Assil Mahamid
Miri Elgabsi
Muhammad Khatib
Hamza Murad
Feras Qawasmi
Eitan Lavon
Sana Zahalka
Ali Yassin
Mustafa Yassin
June 14, 2026

Archives Of Orthopaedic And Trauma Surgery

Overview

This study evaluates the impact of rheumatoid arthritis (RA) on postoperative complications and hospitalization outcomes following reverse total shoulder arthroplasty (RTSA). It highlights that RA patients experience higher rates of complications, longer hospital stays, and increased healthcare resource utilization compared to non-RA patients.

Background

Reverse total shoulder arthroplasty (RTSA) is increasingly performed in patients with rheumatoid arthritis (RA), reflecting its growing acceptance as a treatment for advanced shoulder pathology. Understanding the complications associated with RTSA in RA patients is crucial, as they may face unique risks compared to the general population. This study aims to provide insights into these risks using a large national database.

Data Highlights

Outcome	RA Patients	Non-RA Patients
Length of Stay	Longer	Shorter
Acute Blood Loss Anemia	Higher	Lower
Inpatient Complications	Increased	Decreased
Hospital Charges	Higher	Lower
In-Hospital Mortality	Not specified	Not specified

Key Findings

RA patients undergoing RTSA have higher rates of urinary tract infections and pulmonary embolism.
Increased incidence of transfusion requirements and prolonged hospitalizations were noted in RA patients.
Implant-related complications, such as prosthesis-related failures and intraoperative fractures, are more prevalent in RA patients.
Scapular notching and postoperative fractures are frequently observed in this cohort.
Periprosthetic joint infection remains a significant concern, potentially leading to revision procedures.

Clinical Implications

Healthcare providers should be aware of the increased risk of complications in RA patients undergoing RTSA and consider tailored perioperative management strategies. Vigilant postoperative monitoring is essential to address the heightened vulnerability of this patient population.

Conclusion

The findings underscore the need for careful consideration of the risks associated with RTSA in patients with rheumatoid arthritis, highlighting the importance of specialized care in this demographic.