Recovery after shoulder arthroscopy: Inpatient versus outpatient management

Abstract

Introduction: Shoulder arthroscopy is particularly suited to outpatient surgery, thanks to advances in anesthetic and analgesic techniques. The main goal of this study was to compare postoperative recovery after shoulder arthroscopy between outpatient and inpatient management.

Hypothesis: There is no difference in functional recovery between inpatient and outpatient management.

Materials and method: A single-center, single-operator prospective study was conducted. Both groups received patient-controlled analgesia via an interscalene catheter. The inclusion criterion was shoulder arthroscopy for rotator cuff tendinopathy. The choice between inpatient and outpatient management was left to the patient. The study endpoint was postoperative recovery assessed on QOR-15 at days 1, 2, 3, 4 and 7 and on Quick-DASH at 6 weeks.

Results: Forty-nine patients were included, divided into 2 groups. The outpatient (OP) and inpatient (IP) groups were comparable. Reconstructive surgery accounted for 54% of cases in OP versus 62% in IP. There was no significant difference in recovery in the first postoperative days (QOR-15) or at 6 weeks (Quick-DASH) (p>0.05). Pain on visual analog scale (VAS) was significantly greater in OP after discharge home.

Discussion: No significant difference in postoperative recovery was observed between groups. Nevertheless, pain management and patient information for outpatients need improving.

Level of evidence: II, comparative study.

Keywords: Interscalene catheter; Outpatient surgery; Postoperative recovery; Shoulder arthroscopy.