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Is shoulder surgery high risk?

Shoulder surgery is a common orthopedic procedure, with over 300,000 shoulder operations performed in the U.S. every year. While most shoulder surgeries are successful in relieving pain and restoring mobility, there are risks associated with any surgical procedure. Understanding the potential complications can help patients make informed decisions about shoulder surgery.

What are the risks of shoulder surgery?

All surgeries carry some risk, even common procedures like shoulder surgery. While major complications are relatively rare, it’s important for patients to understand the possible risks before consenting to surgery.

Some potential risks and complications of shoulder surgery include:

  • Infection – Uncommon but serious. May require IV antibiotics or additional surgery.
  • Bleeding – Usually minimal but can rarely be severe.
  • Blood clots – Can form in the legs after surgery. May require blood thinners.
  • Nerve injury – Temporary or permanent nerve damage is possible.
  • Anesthesia issues – Breathing or heart problems are rare.
  • Stiffness – Common after surgery and can affect range of motion.
  • Loss of movement – Permanent limitations in range of motion can occur.
  • Instability – If repairs fail, ongoing shoulder instability is possible.
  • Fractures – Uncommon in shoulder surgery but possible.
  • Chronic pain – Uncommon but may require further treatment.
  • Need for revision surgery – If repairs fail, additional surgery may be needed.

These risks cause anxiety for many patients considering shoulder operations. However, complications occur infrequently in experienced hands. Your surgeon will discuss the specific risks based on your individual condition and procedure.

Does age increase risks?

In general, older patients have higher rates of complications after surgery. Issues like diabetes, heart disease, obesity and smoking also raise surgical risk.

Specifically for shoulder surgery, advanced age does appear to increase the chances of complications. Patients over 60 have higher rates of stiffness, infections, nerve injury, and need for revisions. The risks are even higher over age 70.

However, age alone should not be a deterrent from shoulder surgery. Active, healthy seniors can have excellent outcomes. Your medical history is more important than age when assessing surgical risks.

Do certain shoulder surgeries have more risks?

Yes, certain types of shoulder operations have higher inherent risks.

Procedures with higher complication rates include:

  • Total shoulder replacement – Significant complication rate around 10%.
  • Complex reconstruction for instability – More risks with extensive repairs.
  • Reverse total shoulder replacement – More risks than anatomic designs.
  • Fracture surgery – Open repairs have more complications.
  • Infection surgery – Requires extensive debridement.
  • Shoulder resurfacing – Technically difficult so high failure rate.

Surgeries considered lower risk include:

  • Arthroscopic rotator cuff repair
  • Common shoulder stabilization procedures
  • Removal of calcium deposits
  • Subacromial decompression
  • Arthroscopic debridement

Your surgeon can explain if your recommended surgery is considered higher or lower risk.

Do surgeons’ experience and hospital quality affect risk?

Absolutely. Surgeon experience and hospital quality are key factors affecting complication rates.

Studies consistently show that higher volume surgeons have lower complication rates in shoulder surgery. Choosing a surgeon who performs a high number of the specific procedure you need is important.

Likewise, hospitals with dedicated orthopedic departments tend to have better outcomes. Facilities that perform more shoulder replacements, for example, have lower infection rates.

Ask your surgeon about their case volume and the hospital’s shoulder surgery quality statistics.

How can patients reduce risks?

While you can’t eliminate surgical risks entirely, there are steps patients can take to reduce complications:

  • Choose an experienced, high-volume shoulder specialist
  • Have surgery at a facility with an orthopedic focus
  • Follow all pre-op preparation instructions carefully
  • Stop smoking before surgery to prevent healing issues
  • Lose weight if obese to reduce anesthesia risks
  • Carefully follow all post-op protocols and activity restrictions
  • Attend every physical therapy appointment for optimal recovery
  • Notify your surgeon about concerning symptoms after surgery

Proper preparation both before and after surgery is key to minimizing risks and achieving the best outcome.

What are the chances of death from shoulder surgery?

Dying during elective shoulder surgery is extremely rare. The overall risk of death for all types of orthopedic surgery is estimated at 0.1%, or 1 in 1000 patients.

Shoulder replacement surgery has a slightly higher but still very low mortality risk. Reports suggest around 0.43% – 0.7% of patients, or 1 in 200 to 1 in 300, die around the time of shoulder replacement surgery.

In younger, otherwise healthy patients, the chance of dying solely due to elective shoulder surgery is negligible. Any deaths result from underlying health conditions, not the surgery itself.

Conclusion

Shoulder surgery has inherent risks like any operation, but major complications are relatively uncommon. For most patients, the potential benefits outweigh the small chances of serious issues.

To minimize risks, choose an experienced surgeon, follow all preparation and recovery directions diligently, and select a hospital with low complication rates. With proper precautions, shoulder surgery can safely relieve pain and restore function for most patients.