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Number of outpatient shoulder arthroplasties may increase within 5 years

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WAIKOLOA, Hawaii — Outpatient total shoulder arthroplasty for carefully selected patients will be increasingly performed without increased risk of complications or readmissions, according to presenter at Orthopedics Today Hawaii 2016.

“There are a lot of advances in pain control for all aspects of orthopedics, particularly with arthroplasty,” Anthony A. Romeo, MD, said, here. “A big part of this is moving our cases out of medical centers and hospitals, and into surgery centers. So the question is ‘Can you do this for shoulder arthroplasty?’ and the answer is ‘Yes, you can.’ ”

Orthopedic surgeons need to be aware of patients’ use of preoperative narcotics, he said. Studies have shown patients who used preoperative narcotics have worse postoperative functional outcomes scores and satisfaction scores.

Anthony A. Romeo

Romeo said although pain begins with injury, orthopedic surgeons can minimize pain with a pre-emptive, multimodal approach. On the day of surgery in the holding area, shoulder arthroplasty patients at Rush University Medical Center receive pregabalin, celecoxib, intravenous acetaminophen and a scopolamine patch. An ultrasound-guided interscalene technique also is used, and postoperative pain medications are provided.

“This is the future for many of our patients. I believe well over 50% of our patients will have shoulder arthroplasty done on an outpatient basis within the next 5 years,” he said. – by Kristine Houck, MA, ELS

Reference:

Romeo AA. Advances in pain control following shoulder arthroplasty. Presented at: Orthopedics Today Hawaii 2016; Jan. 10-14, 2016; Waikoloa, Hawaii.

Disclosure: Romeo reports he receives royalties from Arthrex and Elsevier; is a consultant for and receives miscellaneous support from Arthrex; and receives basic science/research support from Arthrex, Smith & Nephew, Ossur, Miomed, DJOrtho, Conmed Linvatech and Athletico.