Outpatient shoulder prostheses: Feasibility, acceptance and safety

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Patient Outcomes

Background:

• Outpatient surgery enables same-day discharge without increased patient risk.
• Enhanced recovery protocols have made outpatient lower limb arthroplasty common.
• However, outpatient shoulder arthroplasty rates remain low in France (1.1% in 2017).

Purpose of the Study:

• Assess early morbidity and mortality after outpatient shoulder arthroplasty.
• Validate eligibility and safety criteria for this procedure.
• Evaluate patient acceptance of outpatient shoulder surgery.

Main Methods:

• Single-center retrospective study of primary shoulder arthroplasty patients (ASA I-II).
• Inclusion criteria: no cognitive or thromboembolic diseases.
• Discharge criteria: PADSS >9/10 and VAS <5/10.
• Follow-up included telephone interviews and clinical/radiologic assessments at 1 and 6 months.

Main Results:

• Of 36 patients offered, 24 accepted outpatient shoulder arthroplasty.
• No readmissions or complications were reported in the 19 successfully discharged patients.
• All patients were satisfied with functional outcomes; 84% were satisfied with outpatient management.
• 12% refused same-day discharge, and 8% were not discharged due to medical reasons.

Conclusions:

• Outpatient shoulder arthroplasty is safe for selected patients with low comorbidities.
• Patient acceptance of outpatient shoulder arthroplasty is currently low.
• Improved patient education is recommended to increase acceptance of outpatient surgery.