Outpatient vs. inpatient reverse total shoulder arthroplasty: outcomes and complications

Erickson, Brandon J.; Shishani, Yousef; Jones, Stacy; Sinclair, Tia; Griffin, Justin W.; Romeo, Anthony A.; Gobezie, Reuben

doi:10.1016/j.jse.2019.10.023

Cited by 40 publications

(96 citation statements)

References 16 publications

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“…At 12 month follow-up, Cancienne et al [8] and Arshi et al [29] found no statistically significant difference in TSA revision at 12 months. Similarly, Erickson et al [18] reported no difference in revision between both groups at 24 months. In addition, our meta-analytic comparison resulted in an OR of 1.02 [95% CI 0.75, 1.39] (I 2 = 0%) when pooling the revision rates at a follow-up period ranging from 12 to 24 months (Fig.…”

Section: Complications and Revisionsmentioning

confidence: 90%

“…In non-database studies, only the study by Erickson et al [18] found that outpatient TSA had lower overall complications (7% vs 12.7%; P = 0.23). All other four nondatabase The total number of surgical complications in the outpatient group was 174 (2.6%), of which 114 (1.7%) were major and 60 (0.9%) were minor surgical complications ( Table 3).…”

Section: Complications and Revisionsmentioning

confidence: 96%

“…This requires tremendous cooperation across several stakeholders such as surgeons, anesthesiologists, nurses, administration, insurance agencies, and rehabilitation services [15]. Several studies have shown that adjusting patient expectations, proper patient education, inquiry about living status such as the availability of assistance at home, and proximity to the surgical centre are crucial when considering outpatient pathways [16][17][18][19]. Furthermore, pain management should be carefully planned with the anaesthetists which can include preemptive analgesia, brachial plexus catheters, interscalene blocks, peri-articular injections, and post-operative multimodal pain management [16,20].…”

Section: Level Of Evidence: III Therapeuticmentioning

confidence: 99%

“…Eight [8,16,17,19,[25][26][27][28] out of the ten studies reported readmission rates and nine studies reported postoperative complications. Two studies [8,25] reported costs in the form of total charges or cost per patient, and one study [18] reported shoulder functional scores. The summary of the included studies is provided in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

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The safety of outpatient total shoulder arthroplasty: a systematic review and meta-analysis

Ahmed

Hantouly

Toubasi

et al. 2021

International Orthopaedics (SICOT)

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Purpose To meet the increasing demands of total shoulder arthroplasty (TSA) while reducing its financial burden, there has been a shift toward outpatient surgery. This systematic review and meta-analysis aimed to evaluate the safety of outpatient TSA. Methods The primary objective was to compare re-admission rates and postoperative complications in outpatient versus inpatient TSA. The secondary objectives were functional outcomes and costs. PubMed, Google Scholar, and Web of Science were searched until March 28, 2020. The inclusion criteria were studies reporting at least complications or readmission rates within a period of 30 days or more. Results Ten level III retrospective studies were included with 7637 (3.8%) and 192,025 (96.2%) patients underwent outpatient and inpatient TSA, respectively. Outpatient TSA had relatively younger and healthier patients. There were no differences between outpatient and inpatient arthroplasty for 30- and 90-day readmissions. Furthermore, unadjusted comparisons demonstrated significantly less total and major surgical complications, less total, major, and minor medical complications in favour of outpatient TSA. However, subgroup analyses demonstrated that there were no significant differences in all complication if the studies had matched controls and regardless of data source (database or nondatabase studies). The revision rates were similar between both groups at a 12–24 months follow-up. Two studies reported a significant reduction in costs in favour of outpatient TSA. Conclusion This study highlights that outpatient TSA could be a safe and effective alternative to inpatient TSA in appropriately selected patients. It was evident that outpatient TSA does not lead to increased readmissions, complications, or revision rates. A potential additional benefit of outpatient TSA was cost reduction.

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Section: Complications and Revisionsmentioning

confidence: 90%

Section: Complications and Revisionsmentioning

confidence: 96%

Section: Level Of Evidence: III Therapeuticmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

The safety of outpatient total shoulder arthroplasty: a systematic review and meta-analysis

Ahmed

Hantouly

Toubasi

et al. 2021

International Orthopaedics (SICOT)

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“…By shifting the center of rotation (COR), the Grammont design and the more recent reverse shoulder prosthesis designs achieve an improvement of the abductor lever arm of the deltoid muscle, therefore compensating for deficiencies of the cuff or loss of the tuberosities [5,9,10]. Although reverse prostheses are used in growing numbers, they are accompanied by high rates of complications of up to 60% [2,3,11]. Besides infections, periprosthetic fractures, and loosening, a common cause of failure of reverse prostheses is instability [5,13,15].…”

Section: Influence Of Glenosphere Diameter and Lateralization On Instmentioning

confidence: 99%

Influence of glenosphere diameter and lateralization on instability of reverse shoulder arthroplasty

et al. 2020

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Background Prosthetic replacement of the proximal humerus with reverse shoulder arthroplasty (RSA) is an established means of treatment. Due to its unique biomechanical characteristics, RSA can restore shoulder function to a satisfying level in the case of cuff tear arthropathy, arthritis, and fractures. However, complications are frequent in RSA, one of the more common being implant instability with dislocation. The present study investigated the influence of glenosphere diameter and metaglene lateralization using a unique test setup. Methods Seven fresh-frozen cadaveric specimens of the shoulder were thawed and dissected. The subscapularis muscle, the infraspinatus, and the three heads of the deltoid muscle were fixed to a pulley system. After implanting an RSA in different configurations (38/42 mm glenosphere with lateralization of +0 mm, +5 mm, or +10 mm), the implants were dislocated using selective muscle pull. The frequency of dislocations depending on the prosthesis configuration was documented. Results The larger glenosphere diameter of 42 mm showed less dislocations than the diameter of 38 mm (39 vs. 46). Lateralization of +0, +5 mm, and +10 mm showed 26, 29, and 30, dislocations, respectively. Dislocation via pull on the infraspinatus muscle was most frequent. None of the results reached statistical significance. Conclusion The current investigation used a novel technique for investigating the effect of lateralization and glenosphere diameter on RSA instability. Despite indicating tendencies, the present test setup could not prove the hypothesis that a larger glenosphere diameter and increased lateralization add to stability. The lack of statistical significance could be attributable to the low specimen number. The clinical significance of lateralization and glenosphere diameter should be further assessed in future biomechanical investigations.

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Outpatient versus inpatient total shoulder arthroplasty: A meta-analysis of clinical outcomes and adverse events

Daher,

Cobvarrubias,

Boufadel

et al. 2024

International Orthopaedics (SICOT)

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Outpatient vs. inpatient reverse total shoulder arthroplasty: outcomes and complications

Cited by 40 publications

References 16 publications

The safety of outpatient total shoulder arthroplasty: a systematic review and meta-analysis

The safety of outpatient total shoulder arthroplasty: a systematic review and meta-analysis

Influence of glenosphere diameter and lateralization on instability of reverse shoulder arthroplasty

Outpatient versus inpatient total shoulder arthroplasty: A meta-analysis of clinical outcomes and adverse events

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