Shoulder arthroplasty has traditionally been viewed as an inpatient procedure because of the inherent medical comorbidities associated with an aging population and the need for postoperative pain control. Recent studies have shown that in appropriately selected patients, shoulder arthroplasty procedures can be safely done as outpatient procedures and can deliver economic value in today's cost-conscious health care environment. Several factors help ensure a successful surgical outcome, including cooperation from the ambulatory anesthesia service, proper patient selection, and perioperative pain control. Postoperatively, provider availability is vital to complete a seamless patient experience. With appropriate algorithms and care plans in place, outpatient shoulder arthroplasty can be a safe and cost-efficient procedure. The advances pioneered by outpatient shoulder arthroplasty will also serve to benefit inpatient shoulder arthroplasty patients via improved pain control, perioperative education, and potentially decreased length of stay.
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J Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. Electronic address:
Objectives: Rheumatoid arthritis often leads to debilitating damage in the elbow joint, which may require total elbow arthroplasty (TEA). The Kudo TEA is one of the unlinked type prostheses with reportedly favorable outcomes. However, there is limited information available regarding its long-term performance.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
December 2024
Department of Orthopaedic Surgery, Royal North Shore Hospital, St Leonards, Australia.
Background: Proximal humerus fractures (PHF) are common with approximately 30% requiring surgical intervention. This ranges from open reduction internal fixation (ORIF) to shoulder arthroplasty (including hemiarthroplasty, total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA)). The aim of this study was to assess trends in operative interventions for PHF in an Australian population.
View Article and Find Full Text PDFJ Imaging
December 2024
Department of Orthopedic Research, Arthrex, 81249 Munich, Germany.
Objective: This study evaluated the effect of three-dimensional (3D) volumetric humeral canal fill ratios (VFR) of reverse shoulder arthroplasty (RSA) short and standard stems on biomechanical stability and bone deformations in the proximal humerus.
Methods: Forty cadaveric shoulder specimens were analyzed in a clinical computed tomography (CT) scanner allowing for segmentation of the humeral canal to calculate volumetric measures which were verified postoperatively with plain radiographs. Virtual implant positioning allowed for group assignment (VFR < 0.
Shoulder Elbow
December 2024
Specialty Orthopaedic Upper Limbs Surgery Research Foundation, Bella Vista, NSW, Australia.
Background: This study aimed to determine the revision outcome between a centrally fixed stemless anatomic design and other total anatomic shoulder replacements using data from a large national arthroplasty registry.
Methods: The study period was from December 2011 to December 2022 and included three cohorts; primary Affinis stemless anatomic (AFS), all other primary total stemless anatomic (sTSA) and primary total stemmed anatomic shoulder arthroplasty (aTSA). The endpoint was all-cause revision using cumulative percent revision (CPR).
J Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA. Electronic address:
Introduction: Higher perioperative opioid use has been associated with an increase in periprosthetic joint infection, thromboembolic complications, respiratory events, gastrointestinal complications, cost, and length of stay following hip and knee arthroplasty. Limited data exists regarding the relationship between the postoperative opioid dose and complication rates following primary total shoulder arthroplasty (TSA). The purpose of this study is to investigate the relationship between perioperative opioid consumption and postoperative complications following TSA.
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