Wednesday, September 17, 2025

For want of a nail, the kingdom was lost: a causal model


In the last several posts we'ved talked about an approach to failure analysis through causal modeling.

On a somewhat more lighthearted note, here's an old proverb with a causal model:

*the shoe was lost for want of a nail (A horseshoe nail is missing when a horse is being shod.)


*the horse was lost for want of a shoe (the shoe falls off during riding)



*the rider was lost for want of a horse (without the shoe, the horse stumbles)


*the battle was lost for want of the rider (the rider cannot continue, so his part in the battle fails)


*the kingdom was lost for want of a battle (losing the battle means the kingdom is lost—all because of one missing nail)

Counterfactual: if there had been a nail to fix the shoe, the kingdom would not have been lost.


Here's an analogous causal model of glenoid component failure:


*the quality of glenoid component seating was lost for want of good bone preparation

*secure bony support of the component was lost for want of good component seating

*glenoid component stability was lost for want of secure bony support of the component 

*patient comfort and function were lost for want of glenoid component stability

*survivorship of the glenoid component was lost for want of patient comfort and function


Counterfactual: if there had been better bone preparation, the glenoid component would have survived



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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link)
Shoulder rehabilitation exercises (see this link).