Hematoma Following Shoulder Arthroplasty: Incidence, Management, and Outcomes

Document Type : RESEARCH PAPER

Authors

1 925 Chestnut St 5th Floor

2 Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA

3 Thomas Jefferson University Hospital, Philadelphia, PA

4 Baylor College of Medicine

5 Rothman Orthopaedic Institute

6 Rothman Orthopaedic Institute- Thomas Jefferson University

Abstract

BACKGROUND
A paucity of data regarding the implications of postoperative hematoma formation on outcomes after shoulder arthroplasty exists. Previous studies on major joint arthroplasty have associated postoperative hematoma formation with high rates of prosthetic joint infection (PJI) and reoperation.
METHODS
6,421 shoulder arthroplasty cases were retrospectively reviewed (5,941 primary, 480 revision) between December 2008 and July 2017. Patients who developed a postoperative hematoma were identified through direct chart review. Patients with history of shoulder infection treated with explant and antibiotic spacer placement were excluded. Demographics, surgical characteristics, treatment course, and outcomes were collected.
RESULTS
Hematoma occurred in 105 (1.6%; 105/6421) cases within the first three postoperative weeks and was more common following revision (3.3%; 16/480) compared to primary cases (1.5 %; 89/5941; p=0.002). Overall, postoperative shoulder hematoma was successfully managed with nonoperative treatment in 87% of cases via observation (62%, 62/105) and aspiration (25%, 26/105). Fourteen patients (0.22%, 14/6421) underwent reoperation for hematoma. Eight patients (7.6%, 8/105) that required reoperation for hematoma were diagnosed with PJI.
CONCLUSION
The incidence of postoperative hematoma following shoulder arthroplasty is significant. While many postoperative hematomas can be managed without operative intervention, this analysis reiterates the association between hematoma formation and the development of PJI.

Keywords

The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 05 April 2022

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History

  • Receive Date: 10 August 2020
  • Revise Date: 05 March 2022
  • Accept Date: 09 March 2022
  • First Publish Date: 05 April 2022

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