*3.2. Complications*

There were no readmissions in either group. Complication rates were higher for the rTSR (*n* = 18 in 14 patients) than for the aTSR group (*n* = 3 in 3 patients) (Table 6).

**Table 6.** Postoperative complications for both types of shoulder replacements. Acromioclavicular joint (ACJ) pain is common among aTSR and rTSR, and can be resolved by injections or arthroscopic excision of the distal clavicle (EDC). The main complications for rTSR are stress fractures (#) of the acromion or the scapular spine. The category "Other" reports one case with an avulsion fracture of the triceps. Percentages (%) are based on total number of patients available at 2-year follow-up (aTSR *n* = 44; rTSR *n* =43).


One common complication seen in both groups was acromioclavicular joint (ACJ) pain. This occurred in two shoulders with an aTSR and in six shoulders with an rTSR. Most patients recovered well after a steroid injection, however in two cases (one case in each group), an arthroscopic excision of distal clavicle (EDC) was necessary with a good result.

One patient with an aTSR (Table 6) developed cuff failure. The MRI scan demonstrated a massively retracted and atrophied supraspinatus tendon by the time of presentation. As the shoulder joint was stable, AE was good (>90◦) and there was no pain throughout the 2-year follow-up period, no revision surgery was undertaken.

Apart from the ACJ pain, the main other complication for the rTSR group was a stress fracture of the acromion or the scapular spine (*n* = 11), which mostly occurred within the first year, after patients began unrestricted use of the arm (Table 6). All cases resolved nonoperatively with rest for up to 3 months in an abduction pillow. One rTSR case had an avulsion fracture of the posterior inferior glenoid by the long head of the triceps 10 months after surgery. There was no functional deficit and only mild pain, which resolved after 2 months with nonoperative treatment.
