J Shoulder Elb Arthroplast. 2026 Jul 15;10(4):100061. doi: 10.1016/j.jsea.2026.100061. eCollection 2026 Dec.
ABSTRACT
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is an uncommon but potentially serious complication following total shoulder arthroplasty. This study evaluated patient factors associated with post-operative (PO) VTE after anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA).
METHODS: A retrospective cohort study was performed using the PearlDiver database. Patients undergoing primary aTSA or rTSA with at least 120 days of follow-up were identified using International Classification of Diseases, 10th edition procedure codes. VTE within 90 days post-operatively was the primary outcome. Logistic regression evaluated demographic characteristics, comorbidities, length of stay, Charlson Comorbidity Index, and prior VTE history as predictors of PO VTE.
RESULTS: A total of 42,014 patients underwent aTSA and 93,358 underwent rTSA. PO VTE occurred in 256 (0.61%) patients after aTSA and 767 (0.82%) after rTSA. Increased length of stay, higher Charlson Comorbidity Index, obesity, congestive heart failure, prior valve replacement, renal disease, hepatobiliary disease, and pulmonary disease were associated with increased odds of VTE following both procedures. Diabetes, coronary artery disease, hypertension, malignancy, and rheumatoid arthritis were additional risk factors following rTSA. Among 4,576 patients with a prior VTE, 464 (10.14%) experienced recurrent PO VTE, corresponding to a 25-fold increase in odds compared with patients without prior VTE (odds ratio, 25.68; P < .001).
CONCLUSION: PO VTE occurred in fewer than 1% of patients after primary shoulder arthroplasty. Several comorbidities were associated with increased VTE risk, while prior VTE was the strongest predictor of recurrence. These findings may assist in identifying patients who warrant heightened perioperative VTE risk assessment.
PMID:42604140 | PMC:PMC13476626 | DOI:10.1016/j.jsea.2026.100061