Revision reverse total shoulder arthroplasty as an outpatient procedure

Outpatient arthroplasty offers several benefits, including reduced hospital stay, lower costs, and decreased risk of hospital-acquired infections. The purpose of this study is to compare short-term outcomes, including complication rates, readmissions and reoperations, between inpatient and outpatient revision reverse total shoulder arthroplasty (rTSA).

All revision rTSA performed from July 2013 and January 2024 were retrospectively analyzed. Patients were evaluated based on whether they had the surgery performed as an inpatient or as an outpatient, which was defined as discharged without an overnight stay. Complications within the first 90 days, including readmission and reoperation, were compared between the 2 groups, and a P value of < .05 was considered to be statistically significant.

A total of 228 revision rTSA were performed during the study period with 113 patients receiving surgery in the outpatient setting and 115 patients receiving surgery in the inpatient setting. No patients who had a planned outpatient surgery required conversion to inpatient status following surgery. Of those surgeries completed in the inpatient setting, the average length of stay was 2.8 (±2.4, range [1-15 days]). There were no significant differences in the rates of emergency department visits for all reasons within 90 days (6.2% vs. 10.4%; P = .25), emergency department visits that may reasonably be related to surgery within 90 days (4.4% vs. 9.6%; P = .13), or readmission rates within 90 days (5.3%, vs. 7.8%; P = .46) between the outpatient and inpatient groups, respectively. Three patients (2.7%) in the outpatient cohort and 6 patients (5.2%) in the inpatient cohort required further open surgical procedures, such as revisions in the first 90-days following initial revision procedure, however this was not a significant difference (P = .32).

Revision rTSA can performed as an outpatient procedure, based upon surgeon preference for setting, with no difference in readmission, reoperation, and postoperative complications compared to those performed as an inpatient procedure.