Reverse shoulder replacement: a day-case procedure

Reverse shoulder arthroplasty (RSA) is an increasingly popular treatment modality for glenohumeral joint arthritis in association with rotator cuff arthropathy. A prolonged hospital stay following joint arthroplasty risks increased complications for patients plus financial implications for institutions. We hypothesized that RSA could be safely and effectively carried out as an outpatient procedure with reduced risks to patients and institutional costs.

Patients attending our institution for RSA during March 2015 to August 2018 were reviewed preoperatively for consideration for RSA as an outpatient procedure. The inclusion criteria were arthritis of the shoulder having failed conservative management, age older than 50 years, and intact deltoid muscle function. Patients were excluded if they underwent RSA for trauma or for revision following previous total shoulder replacement or hemiarthroplasty. Overall health, social circumstances, and individual wishes were considered.

A total of 21 patients underwent RSA as an outpatient procedure. The mean age was 74 years (range, 59-84 years). There were 8 male and 13 female patients. No overnight stays were required in patients in whom outpatient surgery was planned. The Oxford Shoulder Score increased from a mean of 16 (range, 4-30) preoperatively to a mean of 31 (range, 7-35) at 6 months postoperatively; it was a mean of 36 (range, 7-48) at 12 months postoperatively. Of the patients, 88% were "very satisfied" or "satisfied" with the service and 81% would undergo the surgical procedure again as a day-case procedure.

RSA as an outpatient procedure can be carried out effectively with high patient satisfaction rates in carefully selected patients.