Sunday, June 12, 2016

If I have a total shoulder, how likely am I to have complications?

Risk prediction is a risky business. However, it is important for patients and surgeons to recognize and manage the factors that may contribute to increased surgical risk.

The American College of Surgeons has put up the surgical infection risk calculator as shown in this link

The home page looks like this

After acknowledging the disclaimer, the data are entered by the patient or the surgeon on this page. Note that the code to be entered in the procedure field for total shoulder is 23472. What is most important here is the list of factors that are associated with increased risk.

The results for an otherwise healthy man of height 74 in and weight 200 pounds is shown below.

It is important to recognize that each of these adverse outcomes is a risk of shoulder joint replacement.

We know that in the shoulder world, there are additional risk factors not included in this list, such as prior surgeries, recent cortisone injections in the shoulder, inflammatory arthropathy, and low serum albumin.