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Updated: Jan 3, 2026

Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Enhanced Recovery After Surgery: Concepts and Application to Total Shoulder Replacement
Thomas W Wainwright1, Tikki Immins, Johannes H A Antonis
1Thomas W. Wainwright, PgDip, PgCert, BSc (Hons), MCSP, Associate Professor in Orthopaedics, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom; and Orthopaedic Department, The Royal Bournemouth Hospital, Bournemouth, United Kingdom. Tikki Immins, MSc, BSc (Hons), Research Development Manager, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom. Johannes H. A. Antonis, MD, Orthopaedic Surgeon, Hip Fellow, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom; and Orthopaedic Department, The Royal Bournemouth Hospital, Bournemouth, United Kingdom. Richard Hartley, MBBS, FRCS (Eng), FRCS (Orth), Consultant Orthopaedic Surgeon, Orthopaedic Department, The Royal Bournemouth Hospital, Bournemouth, United Kingdom. Robert G. Middleton, MA, MBBchir, FRICS, FRICS (Orth), CCST, Consultant Orthopaedic Surgeon, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom; and Orthopaedic Department, The Royal Bournemouth Hospital, Bournemouth, United Kingdom.
Background:
Enhanced Recovery After Surgery (ERAS) focuses on optimizing each element on a treatment pathway and encouraging the patient to actively engage in his or her recovery and rehabilitation. It requires collaboration across a multidisciplinary team and has been successful in improving patient outcomes, length of stay (LOS), and costs for a wide range of surgical procedures, including musculoskeletal surgeries such as total hip and total knee replacement.
Purpose:
To examine the application of ERAS concepts to total shoulder replacement (TSR) surgery.
Methods:
Hospital Episode Statistics (HES) in England on LOS for TSR surgery were examined, and a review of literature on the use of ERAS concepts in TSR was undertaken.
Results:
Analysis of HES data suggested scope for improvement in reducing LOS. A review of the literature found some evidence of the use of ERAS concepts, particularly in multimodal pain management.
Conclusions:
Future research is now required for ERAS procedure-specific components for TSR surgery.
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