Shoulder replacement 'more dangerous' than previously thought and may not be worth the risk

Shoulder replacement surgery is far more dangerous than previously thought and may not be worth the risk for many patients, a study by Oxford University has concluded.

The first major analysis of the long-term outcomes of patients who underwent the procedure found that complex revision surgery was needed in one in four people among certain groups.

The researchers also found a higher rate of post-surgical adverse events such as heart attacks, major blood clots and infections, than was previously thought to occur.

Published in the BMJ, the study follows a five-fold increase in shoulder replacements over the past two decades, with more than 5,691 people undergoing the procedure in 2016.

The findings show that one in four men aged between 55 and 59 is at risk of needing revision surgery, particularly during the first five years after a shoulder replacement.

Meanwhile the risk of any serious adverse event at 30 days post-surgery was 1 in 28, and at 90 days post-surgery was 1 in 22.

The research team said patients undergoing the procedure should be warned of the risks so they can make an informed choice.

Dr Richard Craig, at the University of Oxford, said: "Although the number of replacements do not yet match those of the hip and knee, recent trends from international joint replacement registries show a rapid increase in the incidence of primary shoulder replacements performed and the rapid adoption of newer implant technologies.

"Despite this growth, no large scale trials and very few published studies have been carried out on the long term outcomes across different age groups, including the risks of revision surgery.

"A small study with short follow-up suggested that the risk of early revision surgery might be greater in those aged less than 59 years."