ArticleCureus2026
Increased Risk of Medical and Implant-Related Complications in Patients With Atrial Fibrillation After Primary Total Shoulder Arthroplasty: A 1:1 Propensity-Matched Cohort Analysis.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAtrial fibrillation (AF) is a common cardiac comorbidity associated with increased risk of bleeding and complications following surgery. Few studies have evaluated the impact of preoperative diagnosis of AF on complications following primary total shoulder arthroplasty (TSA). The purpose of this study is to evaluate the risk of 90-day and two-year postoperative medical and implant-related complications in patients undergoing TSA with a diagnosis of AF.
methodsA multicentre database, TriNetX (TriNetX, LLC, Cambridge, MA, USA), was queried for patients who underwent primary TSA between 2013 and 2023. After exclusion criteria, patients were divided into two cohorts: those diagnosed with a preoperative diagnosis of AF prior to TSA and those without a preoperative diagnosis of AF (non-AF). The AF and non-AF cohorts were propensity-matched in a 1:1 ratio. Medical complications included sepsis, infection, stroke, pneumonia, renal failure, myocardial infarction (MI), venous thromboembolism (VTE), hemorrhage, blood transfusion, wound dehiscence, superficial surgical site infection (SSI), deep SSI, organ/space SSI, readmission, and mortality. Implant-related complications include revision TSA, periprosthetic joint infection (PJI), periprosthetic fracture, dislocation, and mechanical loosening.
resultsThree thousand eight hundred sixty-four patients were included in each cohort after propensity matching, accounting for any significant differences in patient demographics or comorbidities. Within 90 days following primary TSA, patients with AF showed a significantly increased risk of stroke, pneumonia, and VTE compared to the non-AF cohort (p < 0.05). Within two years following TSA, patients with AF showed a significantly increased risk of stroke, pneumonia, VTE, MI, renal failure, blood transfusion, mortality, total implant-related complication rate, and PJI compared to the non-AF cohort (p < 0.05).
conclusionPreoperative diagnosis of AF is associated with an increased risk of 90-day and two-year medical and implant-related complications following primary TSA. Surgeons should be aware of these risks to better optimize their patients.
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