Intraoperative Axillary Artery Injury as a Complication of Reverse Total Shoulder Arthroplasty

ABSTRACT Axillary artery injury as a result of total shoulder artroplasty is a fairly rare complication. Isolated clinical observations are described in foreign articles, there are no reports of domestic authors about this problem. There is a need for more extensive coverage of this problem in order to prevent similar situations in the future.THE AIM of this publication is to present a clinical case of intraoperative axillary artery injury in the process of reverse shoulder arthroplasty, and the medium­ term result of surgical treatment after replacement of the artery defect with a synthetic graft.MATERIAL AND METHODS We present a rare clinical case of intraoperative axillary artery injury in the process of reverse shoulder arthroplasty. After the replacement of the artery defect by a team of vascular surgeons, it was decided to continue the shoulder joint replacement surgery. In the postoperative period, computed tomography angiography revealed occlusion of the restored section of the axillary artery, but the presence of collateral blood flow distal to the injury zone, the preservation of active movements in the joints of the right upper limb, and the absence of sensitivity disorders in the right hand made it possible to refrain from repeated surgical intervention. When evaluating the medium­term results 15 months after surgical treatment, a significant limitation of the function of the right upper limb was noted in the complete absence of pain syndrome.CONCLUSION The presented clinical case demonstrates the experience of managing a patient with simultaneous reverse shoulder arthroplasty and an intraoperatively damaged section of the axillary artery with the achievement of complete absence of pain syndrome with significant restriction of function in the remote period. Bearing in mind the possible damage to the main arteries, particularly in age­related patients, and the amount of medical care required in the event of this complication, it is recommended that medical care be provided in a multidisciplinary hospital with a team of vascular surgeons.