Our Summary

This research paper discusses Venous thromboembolism (VTE), a rare but known complication of shoulder surgery. VTE is a condition where blood clots form in the veins, which can be dangerous if they travel to the lungs. Rates of VTE after shoulder surgery vary widely, from as low as 0.2% to as high as 16%. Unlike hip and knee surgeries, there aren’t established guidelines for using medication to prevent VTE after shoulder surgeries, and some argue it’s not necessary. However, using physical methods to prevent VTE, such as special stockings or devices that promote blood flow, is widely accepted, especially for longer surgeries. Because VTE is rare in shoulder surgeries, treatments are often based on what’s been effective for hip and knee surgeries. Recent studies have identified some risk factors for VTE related to the patient and the surgery itself. Surgeons should be aware of these risk factors and discuss them with patients as part of the consent process. More research is needed with larger groups of patients to better prevent VTE in shoulder surgeries.

FAQs

  1. What is the reported rate of venous thromboembolism (VTE) in shoulder arthroplasty?
  2. What are some of the risk factors for developing VTE after a shoulder surgery?
  3. Why are chemical prophylactic guidelines for VTE not established in shoulder surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about shoulder replacement is to be aware of the risk of venous thromboembolism (VTE) following surgery. While the risk of VTE after shoulder surgery is relatively low, it is still important for patients to be aware of the potential complication and to take necessary precautions. This may include following recommendations for mechanical prophylaxis, such as wearing compression stockings or using intermittent pneumatic compression devices, as well as discussing any potential risk factors with their healthcare provider. It is important for patients to be informed about VTE prevention measures and to communicate openly with their healthcare team to ensure the best possible outcome following shoulder replacement surgery.

Suitable For

Patients who are typically recommended for shoulder replacement surgery include those with severe shoulder arthritis, significant pain and limited range of motion in the shoulder joint, failed previous shoulder surgery, and fractures or severe injury to the shoulder joint. Additionally, patients who have not had success with conservative treatments such as physical therapy, cortisone injections, and medications may also be candidates for shoulder replacement surgery. It is important for patients to discuss their individual case with their orthopedic surgeon to determine if shoulder replacement is the best treatment option for them.

Timeline

Before shoulder replacement surgery, a patient will typically experience chronic shoulder pain, limited range of motion, and difficulty performing daily activities. They may have tried conservative treatments such as physical therapy, medications, and cortisone injections without success. They will undergo a thorough evaluation by their orthopedic surgeon to determine if shoulder replacement is the best treatment option.

After shoulder replacement surgery, the patient will experience pain and stiffness in the shoulder, which is managed with pain medication and physical therapy. They will gradually regain strength and range of motion in the shoulder as they progress through the rehabilitation process. It may take several months for the patient to fully recover and return to their normal activities. Follow-up appointments with the surgeon will be scheduled to monitor the healing process and address any concerns or complications that may arise.

What to Ask Your Doctor

  1. What is the likelihood of developing a venous thromboembolism (VTE) after shoulder replacement surgery?
  2. What are the risk factors for developing a VTE after shoulder replacement surgery?
  3. What steps will be taken to prevent VTE during and after the surgery?
  4. What are the potential complications of VTE and how are they managed?
  5. How soon after surgery should I be on my feet and moving to prevent VTE?
  6. How long will I need to be on blood thinners or other medications to prevent VTE?
  7. Are there any specific lifestyle changes or activities I should avoid to reduce my risk of VTE?
  8. What signs or symptoms of VTE should I watch for and when should I seek medical attention?
  9. How often will I need follow-up appointments to monitor for VTE or other complications?
  10. Are there any specific exercises or physical therapy techniques that can help prevent VTE after shoulder replacement surgery?

Reference

Authors: Mancini MR, LeVasseur MR, Hawthorne BC, Marrero DE, Mazzocca AD. Journal: J ISAKOS. 2021 Sep;6(5):283-289. doi: 10.1136/jisakos-2020-000538. Epub 2021 Mar 11. PMID: 34535553