Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 5;7(2):270-276.
doi: 10.1016/j.jseint.2022.12.015. eCollection 2023 Mar.

Outpatient total shoulder arthroplasty in the ambulatory surgery center: a comparison of early complications in patients with and without glenoid bone loss

Scott P Stephens  1 , Ryan M Decoons  2 , Benjamin W Szerlip  1 , Craig A Goubeaux  3 , Hayden B Schuette  3 , Matthew T Glazier  3 , Abigail M Braden  4 , Luke A Hendrickson  4 , Bruce R Comisar  1
Affiliations

Outpatient total shoulder arthroplasty in the ambulatory surgery center: a comparison of early complications in patients with and without glenoid bone loss

Scott P Stephens et al. JSES Int. .

Abstract

Background: The purpose of this study is to compare the 90-day complications and readmission rates between patients undergoing total shoulder arthroplasty (TSA) in an ambulatory surgery center (ASC) with glenoid bone loss requiring an augmented glenoid component compared to patients without bone loss.

Methods: This is a retrospective cohort study of patients undergoing outpatient TSA at an ASC (2018-2021). Readmission, direct transfer, and complications were recorded. Major and minor complications were compared. Secondary outcomes included operative time, estimated blood loss, range of motion, and patient-reported outcome measures.

Results: There were 44 patients (45 shoulders) included in the study, 20 with augmented implants for glenoid bone loss and 25 nonaugmented with a concentric glenoid. There were no statistical differences in demographics. Two complications were seen in both the augmented and nonaugmented groups (10% vs. 8%). There were no readmissions or direct transfers. The augmented group had significantly increased preoperative glenoid retroversion (23° vs. 9°, P < .05), posterior humeral head subluxation (78% vs. 61%., P < .05), and longer operative time (124.4 min vs. 112.3 min., P < .05). Patient-specific instrumentation was used in 60% of augmented cases and 29% of nonaugmented cases.

Conclusion: There was no significant difference in complications, direct transfers, or readmissions between patients with and without glenoid bone loss being treated in an outpatient ASC. The augmented group had significantly worse preoperative deformities, longer operative times, and increased utilization of patient-specific instrumentation. Outpatient TSA in the setting of glenoid bone loss requiring augmentation was found to be safe and effective at a stand-alone ASC.

Keywords: Ambulatory surgery center; Augmented glenoid; Complication rate; Glenoid deformity; Outpatient; Total shoulder arthroplasty.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A): Preoperative axillary radiograph. (B): Preoperative AP radiograph. (C): Axillary CT demonstrating posterior glenoid bone loss and subluxation. (D): Preoperative planning software with a 25° wedge demonstrating 19° correction. (E): Postoperative AP of RTSA. (F): Postoperative Axillary of RTSA; RTSA, reverse total shoulder arthroplasty.
See this image and copyright information in PMC

References

    1. Anthony C.A., Westermann R.W., Gao Y., Pugely A.J., Wolf B.R., Hettrich C.M. What are risk factors for 30-day morbidity and transfusion in total shoulder arthroplasty? A review of 1922 cases. Clin Orthop Relat Res. 2015;473:2099–2105. doi: 10.1007/s11999-014-4107-7. - DOI - PMC - PubMed
    1. Bean B.A., Connor P.M., Schiffern S.C., Hamid N. Outpatient shoulder arthroplasty at an ambulatory surgery center using multimodal pain management approach. J Am Acad Orthop Surg Glob Res Rev. 2018;2:e064. doi: 10.5435/JAAOSGlobal-D-18-0064. - DOI - PMC - PubMed
    1. Brabston E.W., Fehringer E.V., Owen M.T., Ponce B.A. Stemless humeral implants in total shoulder arthroplasty. J Am Acad Orthop Surg. 2020;28:e277–e287. doi: 10.5435/JAAOS-D-16-00747. - DOI - PubMed
    1. Brolin T.J., Mulligan R.P., Azar F.M., Throckmorton T.W. Neer Award 2016: outpatient total shoulder arthroplasty in an ambulatory surgery center is a safe alternative to inpatient total shoulder arthroplasty in a hospital: a matched cohort study. J Shoulder Elbow Surg. 2017;26:204–208. doi: 10.1016/j.jse.2016.07.011. - DOI - PubMed
    1. Cancienne J.M., Brockmeier S.F., Gulotta L.V., Dines D.M., Werner B.C. Ambulatory total shoulder arthroplasty: a comprehensive analysis of current trends, complications, readmissions, and costs. J Bone Joint Surg Am. 2017;99:629–637. doi: 10.2106/JBJS.16.00287. - DOI - PubMed