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Open Access 01-03-2021 | Review Article

The safety of outpatient total shoulder arthroplasty: a systematic review and meta-analysis

Authors: Abdulaziz F. Ahmed, Ashraf Hantouly, Ammar Toubasi, Osama Alzobi, Shady Mahmoud, Saeed Qaimkhani, Ghalib O. Ahmed, Mohammed Al Ateeq Al Dosari

Published in: International Orthopaedics | Issue 3/2021

Abstract

Purpose

To meet the increasing demands of total shoulder arthroplasty (TSA) while reducing its financial burden, there has been a shift toward outpatient surgery. This systematic review and meta-analysis aimed to evaluate the safety of outpatient TSA.

Methods

The primary objective was to compare re-admission rates and postoperative complications in outpatient versus inpatient TSA. The secondary objectives were functional outcomes and costs. PubMed, Google Scholar, and Web of Science were searched until March 28, 2020. The inclusion criteria were studies reporting at least complications or readmission rates within a period of 30 days or more.

Results

Ten level III retrospective studies were included with 7637 (3.8%) and 192,025 (96.2%) patients underwent outpatient and inpatient TSA, respectively. Outpatient TSA had relatively younger and healthier patients. There were no differences between outpatient and inpatient arthroplasty for 30- and 90-day readmissions. Furthermore, unadjusted comparisons demonstrated significantly less total and major surgical complications, less total, major, and minor medical complications in favour of outpatient TSA. However, subgroup analyses demonstrated that there were no significant differences in all complication if the studies had matched controls and regardless of data source (database or nondatabase studies). The revision rates were similar between both groups at a 12–24 months follow-up. Two studies reported a significant reduction in costs in favour of outpatient TSA.

Conclusion

This study highlights that outpatient TSA could be a safe and effective alternative to inpatient TSA in appropriately selected patients. It was evident that outpatient TSA does not lead to increased readmissions, complications, or revision rates. A potential additional benefit of outpatient TSA was cost reduction.

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Title: The safety of outpatient total shoulder arthroplasty: a systematic review and meta-analysis
Authors: Abdulaziz F. Ahmed
Ashraf Hantouly
Ammar Toubasi
Osama Alzobi
Shady Mahmoud
Saeed Qaimkhani
Ghalib O. Ahmed
Mohammed Al Ateeq Al Dosari
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 3/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-021-04940-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The safety of outpatient total shoulder arthroplasty: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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