Impact of rheumatoid arthritis on complications and hospital outcomes following reverse shoulder arthroplasty: evidence from 389,135 hospitalizations in the national inpatient sample - Report - MDSpire

Impact of rheumatoid arthritis on complications and hospital outcomes following reverse shoulder arthroplasty: evidence from 389,135 hospitalizations in the national inpatient sample

  • By

  • Assil Mahamid

  • Miri Elgabsi

  • Muhammad Khatib

  • Hamza Murad

  • Feras Qawasmi

  • Eitan Lavon

  • Sana Zahalka

  • Ali Yassin

  • Mustafa Yassin

  • June 14, 2026

  • 0 min

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Effects of Rheumatoid Arthritis on Postoperative Complications After RTSA

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

OutcomeRA PatientsNon-RA Patients
Length of StayLongerShorter
Acute Blood Loss AnemiaHigherLower
Inpatient ComplicationsIncreasedDecreased
Hospital ChargesHigherLower
In-Hospital MortalityNot specifiedNot 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.

Related Resources & Content

  1. Beauperthuy et al., National Database, 2023 -- Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Nationwide Analysis
  2. 2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline
  3. Outcomes of Trauma-Related Reverse Shoulder Arthroplasty: A Clinical and Radiological Perspective
  4. Non-displaced to minimally displaced intraoperative periprosthetic humeral shaft fractures during reverse total shoulder arthroplasty do not impact short-term clinical and radiographic outcomes.
  5. Archives of Orthopaedic and Trauma Surgery — Ream less, move more: glenoid bone preservation in reverse total shoulder arthroplasty with augmented baseplate
  6. Challenges and Revisions in Short Stem Anatomic and Reverse Shoulder Arthroplasty Techniques
  7. 2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty
  8. Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Nationwide Analysis - PMC
  9. Implant-Positioning and Patient Factors Associated with Acromial and Scapular Spine Fractures After Reverse Shoulder Arthroplasty: A Study by the ASES Complications of RSA Multicenter Research Group - PubMed

Original Source(s)

Impact of rheumatoid arthritis on complications and hospital outcomes following reverse shoulder arthroplasty: evidence from 389,135 hospitalizations in the national inpatient sample

  • by Assil Mahamid, Miri Elgabsi, Muhammad Khatib, Hamza Murad, Feras Qawasmi, Eitan Lavon, Sana Zahalka, Ali Yassin, Mustafa Yassin

  • June 14, 2026

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