Outpatient shoulder arthroplasty: An updated systematic review, meta-analysis, and trial sequential analysis on...

Outpatient shoulder arthroplasty has become increasingly popular in recent years. The aim of this study was to compare clinical outcomes and procedural costs between outpatient and inpatient shoulder arthroplasty.

Five databases were searched from their inception to November 7^th, 2024. Meta-analysis and trial sequential analysis were conducted to compare complications, readmission, revision surgery, and emergency department attendance between the two approaches. Procedural costs were reported descriptively.

Thirty-four studies were included in the review. The meta-analysis revealed that medical complications (OR: 0.59, P = 0.0004) were significantly lower in the outpatient setting. No significant differences in total complications (OR: 0.74, P = 0.06), surgical complications (OR: 0.90, P = 0.59), readmission (OR: 1.08, P = 0.67), revision surgery (OR: 0.85, P = 0.15), or emergency department attendance (OR: 0.93, P = 0.68) were observed between the two approaches. The trial sequential analysis indicated that only the meta-analysis of total complications met the required information size to be considered conclusive and not at risk of random error. Outpatient surgery was associated with significantly lower procedural costs.

Outpatient shoulder arthroplasty is cost-effective and can yield non-inferior outcomes compared to the inpatient approach. However, further research is required to strengthen the evidence base.

IV.