Distal peripheral neuropathy after open and arthroscopic shoulder surgery: an under-recognized complication.
HYPOTHESIS
Distal peripheral neuropathy (DPN) is an under-reported complication after anatomic total shoulder arthroplasty (TSA), reverse shoulder arthroplasty (RSA), and arthroscopic rotator cuff repair (RCR).


METHODS
We conducted a retrospective review of patients undergoing shoulder arthroplasty or arthroscopic RCR by 4 shoulder surgeons during a 2-year period. The primary outcome measure was the diagnosis of DPN, defined as carpal tunnel syndrome, cubital tunnel syndrome, ulnar tunnel syndrome, and distal radial sensory neuropathy. Patient demographics and clinical course of DPN were recorded. Mean follow-up was 21, 15, and 12 months for TSA, RSA, and RCR, respectively.


RESULTS
Postoperatively, 6 of 85 TSA (7.1%), 7 of 57 RSA (12.3%), and 21 of 753 RCR (2.79%) patients were diagnosed with DPN. The most common neuropathy was cubital tunnel syndrome for TSA and RSA and carpal tunnel syndrome for RCR. The risk of DPN was higher for shoulder arthroplasty (TSA and RSA) compared with the RCR group. After nonsurgical treatment of DPN, complete resolution of symptoms occurred in 33.3% of TSA, 42.86% of RSA, and 71.43% of RCR patients. However, 16.7% of TSA, 14.3% of RSA, and 4.76% of RCR patients with DPN required surgical decompression; 100% of the patients undergoing surgical decompression had complete resolution of symptoms.


CONCLUSION
DPN is a relatively common complication after shoulder surgery. When it occurs, DPN will often resolve with nonoperative management. Surgical decompression is an effective treatment option in refractory cases.
['Thomasson|Benjamin G|BG|', 'Matzon|Jonas L|JL|', 'Pepe|Matthew|M|', 'Tucker|Bradford|B|', 'Maltenfort|Mitchell|M|', 'Austin|Luke|L|']
D000368:Aged D000369:Aged, 80 and over D019643:Arthroplasty, Replacement D001182:Arthroscopy D019299:Decompression, Surgical D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010523:Peripheral Nervous System Diseases D012189:Retrospective Studies D017006:Rotator Cuff D012785:Shoulder Joint
Neuropathy shoulder surgery arthroplasty rotator cuff