Modern surgical techniques along with better pain management strategies have allowed many patients undergoing total joint replacement to return to the comfort of their home the same calendar day as their surgical procedure with no hospital stay beyond a few hours in the outpatient center. Key to successful same day joint replacement is good patient preparation in terms of overall health status and patient education in terms of understanding the recovery process. Good surgery in terms of efficiency of process is also very important. Recovery from a 1.5 hours surgery will be different than recovery from a 3.5 hour surgery. Thus, selecting a surgeon with abundant experience in shoulder replacement can mean a substantial difference in time on the table as well as soft tissue handling in the operative field.
When all of these elements are aligned, studies have proven that outpatient shoulder replacement, even when done in an ambulatory surgery center is safe and has a low complication rate and low hospital readmission rate. Risk factors that preclude this are morbid obesity, unaddressed sleep apnea, chronic obstructive pulmonary disease, significant cardiac disease and generalized frailty. Well managed medical problems such as well-controlled diabetes and stable cardiac disease can be considered on a case-by-case basis. Having criteria by which patients can be selected for outpatient versus inpatient care can be helpful but ultimately the experienced surgeon needs to look at the “big picture” to determine which setting is most appropriate.
Dr. Parsons has been performing outpatient shoulder replacement for several years and has performed over 1000 shoulder replacements in his career. He has served on the design team of different implants and an image-guided navigation system. He is an expert in both anatomic and reverse total shoulder replacement using a variety of implant systems which can be custom selected for each patient. He is also an expert in the Ream and Run shoulder replacement. If you suffer from shoulder arthritis or rotator cuff disease, we can help.