The origin story of total shoulders moving to outpatient ORs begins with sports medicine surgeons, who performed complex rotator-cuff repairs in the same-day setting. The procedures took between one to two hours, and patients recovered for at least two hours before discharge. “It’s a high-resource and demanding procedure,” says Anthony Romeo, MD, a shoulder and elbow specialist who practices in Chicago. “Surgeons at my practice realized it would take about the same time — or maybe even less — to perform a shoulder replacement, and the recovery time for patients would be similar.”
In the U.S., close to 800,000 total knee replacements and about 600,000 total hips are performed each year. Dr. Romeo says surgeons perform close to 200,000 shoulder replacements annually. “It’s a smaller volume, but case numbers have increased significantly over the past 10 to 15 years because of innovative technology and new techniques that are making the procedures more effective,” he adds.
The data and literature suggest the number of primary shoulder arthroplasties is increasing exponentially due to the aging population and the growing number of fellowship-trained shoulder reconstruction specialists who are entering the field, according to Michael Khazzam, MD, an associate professor of orthopedic surgery at UT Southwestern Medical Center in Dallas. Even though Dr. Khazzam performs shoulder replacements in the hospital setting, 95% of his patients are discharged the day of surgery. “The majority of my cases are outpatient, and that’s a trend across the nation,” he says. “The pendulum has shifted significantly in that direction.” Capitalizing on that trend and setting your facility up for success in shoulder replacement surgery demands focusing on these key elements: