Over the past 20 to 30 years, arthroscopic shoulder techniques have become increasingly popular. Although these techniques have several advantages over open surgery, surgical complications are no less prevalent or devastating than those associated with open techniques. Some of the complications associated with arthroscopic shoulder surgery include recurrent instability, soft-tissue injury, and neurapraxia. These complications can be minimized with thoughtful consideration of the surgical indications, careful patient selection and positioning, and a thorough knowledge of the shoulder anatomy. Deep infection following arthroscopic shoulder surgery is rare; however, the shoulder is particularly susceptible to Propionibacterium acnes infection, which is mildly virulent and has a benign presentation. The surgeon must maintain a high index of suspicion for this infection. Thromboemoblic complications associated with arthroscopic shoulder techniques are also rare, and studies have shown that pharmacologic prophylaxis has minimal efficacy in preventing these complications. Because high-quality studies on the subject are lacking, minimal evidence is available to suggest strategies for prevention.
From the W.B. Carrell Memorial Clinic, Dallas, TX (Dr. Moen and Dr. Burkhead), the Department of General Orthopedics and Shoulder Surgery, Lakeview Medical Center, Marshfield Clinic, Rice Lake, WI (Dr. Rudolph), Caswell Orthopedic Clinic, New Iberia, LA (Dr. Caswell), McBride Orthopedic Hospital Outpatient Clinic, Oklahoma City, OK (Dr. Espinoza), and The Shoulder Center, Baylor University Medical Center, Dallas, TX (Dr. Krishnan).
Dr. Burkhead or an immediate family member has received royalties from Tornier; is a member of a speakers’ bureau or has made paid presentations on behalf of Tornier, Arthrex, ArthroSurface, and Lima; serves as a paid consultant to Tornier, Wright Medical Technology, Arthrex, ArthroSurface, and Lima; and serves as a board member, owner, officer, or committee member of the International Board of Shoulder and Elbow Surgery. Dr. Krishnan or an immediate family member has received royalties from Tornier; TAG Medical, and Össur; is a member of a speakers’ bureau or has made paid presentations on behalf of and serves as a paid consultant to Tornier; has stock or stock options held in Johnson & Johnson and Tornier; and serves as a board member, owner, officer, or committee member of the American Shoulder Elbow Surgeons and the Arthroscopy Association of North America. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Moen, Dr. Rudolph, Dr. Caswell, and Dr. Espinoza.