As a shoulder and elbow surgeon a lot of operations that I perform involve implanting hardware to help solve someone’s problem. Examples of hardware include plates and screws, joint replacement implants and arthroscopic anchors.
When someone asks whether hardware needs to be removed in the future they usually are referring to plates and screws that help hold fractures together.
Heuristics are “rules of thumb” that people use to make decisions in situations that involve uncertainty. Taleb writes about them in depth and I enjoy his writing. The daily practice of medicine requires making frequent high stakes decision with incomplete knowledge. Where “evidence based medicine” leaves off, heuristics often take over.
I think both doctors and patients use them, but in different ways.
I saw a patient in the office recently whose x-rays were a testament to two important points about shoulder arthritis:
A study from the recent American Arthroscopy Association of North America outlines risk factors for poor outcomes after surgery in patients who have had dislocations. Background: Steve Burkhart popularized the concept of the inverted pear-shaped socket. He found that if more than 1/4 of the bone was missing from the socket after a dislocation and a strictly soft tissue arthroscopic repair was performed to fix it, then these patients would be at high risk for
Below is a typical case of severe arthritis in the ball and socket portion of the shoulder joint.
Arthritis is actually relatively uncommon in this joint. But when it occurs it tends to show a distinct pattern. The hallmark of arthritis at the ball and socket shoulder joint is joint space narrowing bone spurs at the bottom of the ball portion of the joint.
Thanks for visiting my blog. It is focused on issues pertaining to shoulder and elbow conditions and shoulder and elbow surgery. I will share my personal insights with you as a practicing shoulder and elbow surgeon.
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