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For clinicians

Prediction scores

Validated shoulder and elbow prediction and risk scores, reproduced to support calculation in clinic. Each links to an interactive calculator. Use alongside, not instead of, the original published papers and your clinical judgement.

Reproduced scoring tools. These calculators reproduce published scoring systems for convenience and do not replace the original publications, local protocols, or clinical judgement. Confirm inputs and interpretation against the source paper.
Shoulder instability

Instability Severity Index Score (ISIS)

Estimates recurrence risk after arthroscopic Bankart repair for recurrent anterior instability.

Balg F, Boileau P. J Bone Joint Surg Br. 2007;89-B:1470-1477.

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Shoulder instability

Non-operative Instability Severity Index Score (NISIS)

Estimates the risk of failure (recurrence or progression to surgery) when anterior instability is managed non-operatively.

Tokish JM, et al. Sports Health. 2020;12(6):598-602.

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Shoulder instability

Glenoid track (on-track / off-track)

Assesses whether a Hill-Sachs lesion is likely to engage, which informs adding a remplissage or bone block to a stabilisation. Best measured on 3D CT.

Di Giacomo G, et al. Arthroscopy. 2014 (method per Yamamoto and Itoi).

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Rotator cuff

Rotator Cuff Healing Index (RoHI)

Estimates the risk of healing failure after rotator cuff repair from pre-operative factors.

Kwon J, Kim SH, Lee YH, Kim TI, Oh JH. Am J Sports Med. 2019;47(1):173-180.

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Arthroplasty

NJR S-Predict (shoulder replacement)

Estimates the risk of a serious adverse outcome within 90 days of shoulder replacement, to support shared decision-making.

National Joint Registry; model built on NJR data by the Universities of Oxford, Bristol and Copenhagen.

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Fracture

Clavicle non-union risk

Prognostic index for non-union after non-operative treatment of a diaphyseal (midshaft) clavicle fracture.

Robinson CM, Court-Brown CM, McQueen MM, Wakefield AE. J Bone Joint Surg Am. 2004;86-A(7):1359-1365.

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Fracture

Humeral head ischaemia (Hertel criteria)

Flags the risk of head ischaemia and later avascular necrosis after an intracapsular proximal humerus fracture, which informs the fix-versus-replace decision.

Hertel R, et al. J Shoulder Elbow Surg. 2004;13(4):427-433.

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