Outcomes of reverse shoulder arthroplasty as a day case procedure: a population-based cohort study using the National...

Reverse shoulder arthroplasty (RSA) is the most common shoulder replacement in the United Kingdom and has traditionally been an inpatient procedure. Advances in anaesthetic and surgical techniques have made day case RSA increasingly popular, yet published data on its outcomes are limited. This study assesses the outcomes of day case RSA using the National Joint Registry (NJR).

NJR data (April 2012-March 2022) were linked with Hospital Episode Statistics. All patients undergoing RSA for any indication were included. Primary outcomes were revision surgery rates; secondary outcomes included non-revision reoperation, medical complications requiring readmission and patient-reported outcomes for day case vs non-day case patients.

Among 320 day case and 25,748 non-day case RSA patients, day case patients were younger, predominantly male and had lower comorbidity scores. Day case revision rates were 1.45% at 1 year, 1.93% at 3 and 5 years, and 3.96% at 7 years compared with 1.76%, 2.84%, 3.53% and 4.35% for non-day cases. Readmissions for medical complications occurred in 1.56% of day case patients vs 6.34% of non-day cases. Mean Oxford Shoulder Score improvements were 19.83 (±11.32) and 19.16 (±11.80) for day and non-day case groups, respectively.

Day case RSA demonstrates low revision, reoperation and complication rates, with similar patient satisfaction to non-day cases. These findings highlight the safety of day case RSA with careful patient selection and its potential to improve healthcare efficiency from a policy perspective.