ASC-based outpatient, hospital-based inpatient total shoulder arthroplasty prove equally safe: 5 study insights

Written by Jessica Kim Cohen | September 14, 2016 | Print  |

Outpatient total shoulder arthroplasty performed in an ambulatory surgery center is as safe as inpatient total shoulder arthroplasty performed in a hospital, according to a recent study published in the Journal of Shoulder and Elbow Surgery.

The researchers identified 30 patients who received outpatient total shoulder arthroplasty at a freestanding ASC and 30 patients who received the inpatient procedure at a hospital. These two cohorts were matched by both age and comorbidities. The researchers analyzed complications for these patients for 90 days following their procedure, including any readmissions or reoperations.


Here's what you need to know:


1. No patient, in either the ASC or hospital cohort, required reoperation or readmission.


2. The complication rates were not significantly different — the ASC cohort had a complication rate of 13 percent and the hospital cohort had a complication rate of 10 percent.


3. In the ASC cohort, minor complications included arthrofibrosis and mild asymptomatic anterior subluxation.


4. In the hospital cohort, minor complications included mild asymptomatic anterior subluxation, blood transfusion and superficial venous thrombosis.


5. There was one major complication: an outpatient from the ASC cohort fell 11 weeks after surgery, which disrupted his subscapularis repair.


The researchers concluded that outpatient total shoulder arthroplasty is a safe alternative to traditional inpatient total shoulder arthroplasty. However, they emphasize that additional research is needed to evaluate the long-term outcomes of the outpatient procedure.


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