Understanding Medical Optimization for Patients Undergoing Shoulder Arthroplasty

In summary, the rate of TSA has dramatically increased during recent decades and will continue to increase during coming years. With this large increase in total volume of shoulder arthroplasty comes increased numbers of com-plications. The risk of many complications can be significantly reduced with appropriate preop-erative medical optimization of comorbid condi-tions. It is the responsibility of the operating surgeon to understand these conditions, appro-priately screen patients for them, and ensure that they are treated accordingly before surgery. Most of these conditions can be screened for with simple laboratory or clinical tests and treated with either pharmacologic means or life-style modification. Literature has consistently demonstrated that optimizing these conditions preoperatively in the patient undergoing TSA serve to decrease the risk of complications, improve clinical outcomes, and reduce overall health-care costs. However, despite this evi-dence, further research should be performed to clarify best practice for optimization of these comorbidities in TSA specifically in order to establish formative guidelines in this patient population and to identify patient-specific risk profiles for those undergoing TSA.