Patrick Denard reviews infection rates in shoulder replacement surgery, typically 2-4% but under 1% in his practice. He covers prevention strategies including nutrition optimization, skin prep with benzoyl peroxide, sterile technique, and perioperative antibiotics, plus bleeding and transfusion risks.
So what are the complications of shoulder replacement? Well, one of the devastating complications that can occur that people wanna look out for is infection. If you actually look at the data on shoulder replacement, it's somewhere between 2 and 4%. Now there's steps that can be taken to reduce this. Our infection rate in my practice is less than 1%. There's several reasons for this. Number one is we take many steps to prevent infection ahead of time. One is optimizing nutrition. Two is thinking about the bacteria around the skin by doing a prep around the skin with benzoyl peroxide. Three are the steps I take during the surgery to limit the risk of infection. That goes into preparation, how we prep the skin, how we drape everything out in a sterile field, the antibiotics we give prior to the procedure, the irrigation and antibiotics I give during the procedure. And then also important is surgical speed. There's clear data that shows that if people are slower in their surgery, the infection rate goes up. And that's because really what happens is over time inflammation goes up. The longer you are asleep and having a surgery, it creates more trauma. And it's not about moving fast. It's really about eliminating wasted movement. And if you have a team and a system and do it on a regular basis, you can make it an efficient procedure for somebody and reduce the risk of infection. Other complications that occur are much more rare. Things like bleeding, blood transfusion for me is something I never had to have had to give to a person after a primary shoulder replacement. Only very rarely in a revision shoulder replacement setting. There's steps that we take to prevent that. But things can occur like hematoma. With reverse shoulder replacement, there's a unique unique complication, which is acromial stress fracture. And that's because the arm is placed under the ball. That can lead to stress on the acromion bone on the top of the shoulder, leading to a stress fracture that occurs in about 4% of people. We also take steps to try to prevent that, and all that information is in my surgical packet and preparation for shoulder replacement in another video.
