Background: A significant portion of operating room time in shoulder arthroplasty is devoted to nonsurgical tasks. To maximize efficiency and to increase access to care, it is important to accurately quantify surgical and nonsurgical time for shoulder arthroplasty. This study aimed to evaluate surgical vs. nonsurgical time and to assess the viability of using a 1-surgeon, 2-operating room model.
Methods: An institutional database was used to identify all primary and revision shoulder arthroplasty cases from February 2011 through December 2013. Time intervals were analyzed, including anesthesia and positioning time, surgical time, conclusion time, and turnover time.
Results: We identified 1062 shoulder arthroplasties. The average anesthesia and positioning time was 48.2 ± 11.7 minutes, surgical time was 122.7 ± 36.4 minutes, and conclusion time was 10.5 ± 7.0 minutes. Average turnover time at our institution was 40 minutes. An average of 58.8 ± 13.8 minutes (33.2%) of the patient's time in the operating room was not surgical. A 1-room surgical model, with each case following the next, would allow 3 arthroplasties to be performed in a 10-hour surgical day. A 2-room model would allow 4 cases to be performed in a 9-hour surgical day or 5 in an 11-hour day. In this 2-room model, there would be no time in which the surgeon is absent for any surgical portion of the case.
Conclusion: For a high-volume shoulder arthroplasty practice, a 2-room model leads to greater efficiency and patient access to care without sacrificing the surgeon's presence during surgical portions of the case.
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http://dx.doi.org/10.1016/j.jse.2016.11.040 | DOI Listing |
J Shoulder Elbow Surg
January 2025
Palm Beach Shoulder Service HCA Florida Atlantis Orthopedics, Palm Beach, FL, USA; JFK/University of Miami Department of Orthopedics, Lake Worth, FL, USA. Electronic address:
Background: Glenoid bone loss presents a complex challenge in the management of patients with glenohumeral osteoarthritis (GHOA) undergoing Reverse Shoulder Arthroplasty (RSA). Eccentric reaming and bone grafting have been utilized to address this issue but are associated with their own set of challenges. This study explores the effectiveness of augmented glenoid baseplate RSA in addressing glenoid bone loss.
View Article and Find Full Text PDFSkeletal Radiol
January 2025
Department of Radiology, Balgrist University Hospital, Faculty of Medicine, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
Objectives: To evaluate CT imaging findings in symptomatic patients with and without revision surgery (RS) after reverse shoulder arthroplasty (RSA).
Materials And Methods: In this retrospective study, two radiologists assessed CT imaging findings in symptomatic patients with RSA over 5 years, including material fracture and loosening of the peg, baseplate, screws, and humeral stem, screw positioning, prosthesis dislocation, glenoid notching, fractures, and deltoid muscle quality. The primary outcome parameter was RS.
Arthroscopy
January 2025
Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, 925 Chestnut Street 5(th) Floor, Philadelphia, PA 19107.
Purpose: The purpose of this study is to compare postoperative healthcare utilization, prescriptions, and shoulder surgery between patients with an acute depressive episode (ADE) and those without an acute depressive episode (NADE) within 3 months before arthroscopic rotator cuff repair.
Methods: Diagnostic and procedural codes were used to identify patients in the TriNetX Research Network at least 18 years of age and underwent arthroscopic rotator cuff repair between January 2010 and November 2021. Patients with a previous rotator cuff repair or diagnosis of recurrent major depressive disorder were excluded.
Background: Total shoulder arthroplasty frequently is performed in patients with a history of shoulder surgery. The purpose of this study was to evaluate clinical outcomes after primary shoulder arthroplasty in patients with a history of nonarthroplasty shoulder surgery, and whether certain modifiable risk factors (MRFs) were negatively associated with final outcome measures. The secondary purpose was to determine if costs or complications were higher in patients with prior shoulder surgery.
View Article and Find Full Text PDFJSES Int
November 2024
Department of Population Health Sciences, Duke University, Durham, NC, USA.
Background: Identification of high-impact chronic pain (HICP) among patients receiving total shoulder arthroplasty (TSA) may allow for the design and implementation of tailored pain interventions to address the negative impact on postoperative outcomes and quality of life. This analysis sought to determine if Patient-Reported Outcome Measurement Information System (PROMIS) measures could be used to estimate HICP status following TSA.
Methods: This was a secondary analysis of a cohort of patients (n = 227) who received a TSA at a single, academic medical center, of whom 25 (11.
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