Demand for outpatient shoulder replacements is increasing as we continue to see improvements in surgical techniques and multimodal pain management strategies that shorten the length of stay for patients. With the right patient selection and perioperative protocols in place, these procedures can be performed safely and predictably in ambulatory surgery centers.

• Evolving approaches. Shoulder replacements are more minimally invasive thanks to newer stemless or short-stem implant designs, which require minimal prep of the humerus bone and less metal implanted into the body — resulting in less pain for patients and faster post-op recoveries. Individual surgeons, especially those performing high volumes of total shoulder procedures, have proven their ability to handle soft tissue in ways that minimize bleeding or damage, which further limits intraoperative blood loss and post-op pain — critical parts of a surgical technique that lead to the most successful outcomes. Surgeons are further aided by medications such as tranexamic acid (TXA) that are helpful in the perioperative period to decrease blood loss.