分析探讨国内单中心反式肩关节置换术（reverse shoulder arthroplasty，RSA）的并发症发生情况。

回顾了本院164例由单一主刀医生实施的RSA，患者的平均年龄为（70.2±7.98）岁（范围24~85岁），平均随访期为18.6个月（范围1~96个月），评估了与手术相关的并发症的发生率。

总并发症共计25例，发生率为15.2%，其中主要并发症共计13例（7.9%），包括术中发生肩胛盂骨折2例（1.2%）、肱骨近端骨折4例（2.4%）、肱骨干骨折1例（0.6%）、术后出现假体脱位6例（3.6%），其中3例行翻修手术，包含了2例继发假体周围关节感染；次要并发症包括术后出现手指或腕部麻木8例（4.9%），术后出现切口周围疼痛2例（1.2%），术后出现切口愈合不良2例（1.2%）。其中13例主要并发症中有9例发生在前80例的手术中。

这些结果证明RSA在国内应用中并发症可控，其成功实施的核心在于扎实的肩关节理论基础、严格的学习曲线管理及精准的技术细节把控，为该术式在国内的规范化开展提供了重要的循证依据。

Since the mid-1980s, Professor Grammont's design and promotion of reverse shoulder arthroplasty (RSA) has initiated a new area in shoulder joint surgery. Following the FDA approval of RSA in the United States in 2003, its adoption has experienced explosive growth, and RSA has now become an indispensable option for treating various shoulder pathologies. Although initially developed for cuff tear arthropathy (CTA) due to the inability of conventional shoulder arthroplasty to effectively restore stability and function in such cases, its clinical success has expanded its applications to other shoulder conditions. These include massive rotator cuff tears (MRCT) , glenohumeral arthritis with intact rotator cuff, acute proximal humeral fractures, sequelae of proximal humeral fractures, proximal humeral tumors, inflammatory arthropathies, and revision surgeries following failed anatomic total shoulder arthroplasty or hemiarthroplasty. With the increasing utilization of RSA, complication rates have concurrently risen, reported to range between 15%-50%. However, given that RSA is frequently employed for clinically challenging conditions—many representing salvage procedures—the relatively high complication rates are not unexpected. Significant variations in reported complication rates exist across studies due to differing definitions of complications and prosthesis heterogeneity. Improvements in RSA concepts, designs, and surgical techniques have led to evolving complication profiles. For instance, early prosthesis designs were associated with higher rates of scapular notching, while contemporary designs have substantially reduced this complication. Consequently, modern prostheses and surgical techniques demonstrate significantly lower revision rates than earlier generations. Therefore, monitoring complication patterns and incidence remains crucial as RSA indications continue to expand and surgical techniques progress. Compared to international experience, RSA adoption in China began later, with limited complication-related research reported. Exceptionally constrained by single-center case volumes, there remains a paucity of domestic studies analyzing complications in cohorts exceeding 100 cases, highlighting the necessity for further investigation in this field.

To analyze and explore the occurrence of single-center reverse shoulder arthroplasty complications in China.

A review was conducted on 164 cases of RSA performed by a single surgeon in our hospital. The average age of the patients was (70.2±7.98) years (ranging from 24 to 85 years) , and the average follow-up period was 18.6 months (ranging from 1 to 96 months) . The incidence of surgery-related complications was evaluated.

There were a total of 25 cases of total complications, with an incidence rate of (15.2%) . Among them, there were 13 cases (7.9%) of significant complications, including 2 cases (1.2%) of glenoid fractures during the operation, 4 cases (2.4%) of proximal humeral fractures, 1 case (0.6%) of humeral shaft fractures, and 6 cases (3.6%) of prosthesis dislocation after the operation. Among them, 3 cases underwent revision surgery. It included 2 cases of secondary periprosthetic joint infection. Secondary complications included numbness in fingers or wrists in 8 cases (4.9%) after the operation, pain around the incision in 2 cases (1.2%) after the operation, and poor incision healing in 2 cases (1.2%) after the operation. Among the 13 major complications, nine occurred during the operations of the first 80 cases.

These results prove that the complications of reverse shoulder joint replacement surgery are controllable in domestic applications. The core of its successful implementation lies in the solid theoretical foundation of the shoulder joint, strict management of the learning curve, and precise control of technical details, providing an important evidence-based basis for the standardized development of this surgical method in China.