In this article, Dr. Sperling discusses a few advances in shoulder replacement that might make it possible to return home the same day as surgery.
Over the past ten years, there have been significant advances on a wide variety of fronts that have helped lessen post-operative pain and thereby the time in the hospital for patients undergoing shoulder replacement surgery. These advances are allowing some patients to go home the same day as undergoing the replacement surgery. There are multiple potential benefits for the patient to proceed with an outpatient shoulder replacement. This article will touch on some of these advancements that have allowed this transition to occur.
It has become increasingly clear that effective pain management is essential to helping patients return to their normal home surroundings sooner. One of the biggest advancements in joint replacement surgery has been the advent of multimodal anesthesia. Multimodal refers to the concept of using a variety of techniques and medications to minimize pain after surgery.
These techniques can include nerve blocks administered by anesthesiologists, which can occur as a one-time block or sometimes a catheter can be left in place for a longer period of time. Both of these techniques have advantages and disadvantages that you can discuss with your anesthesiologist.
Rather than having their patients receive a nerve block, some surgeons prefer to inject the operative site with local anesthetic agents. There are also many medications that can be used to help minimize post-operative pain. Your surgical team can help explain the different options that may be available for you.
An additional factor that has resulted in decreasing the length of stay is improved surgical instrumentation and joint replacement implants. The development of streamlined instrumentation that is used to prepare the bony surfaces for the implant has resulted in more efficient surgery. A more efficient surgical procedure results in less time under anesthesia for the procedure, which decreases the time to recovery.
In addition to more efficient instrumentation, there has been a rapid development of improved implant sizes and shapes that fit a wide spectrum of the patient population. This allows the surgeon greater flexibility to better match the implant to an individual’s anatomy. Additionally, there are many newer implants that are smaller and preserve more of the patient’s own bone.
Along with advances in anesthesia techniques, surgical instrumentation, and surgical implants, patient education and preparation for surgery has gained greater importance. It’s also important to have a thorough understanding of the recovery process for realistic expectations. In our next article, we will cover some of the things that you can do to prepare if you are having outpatient shoulder replacement surgery.
Outpatient shoulder replacement is not appropriate for all patients due to a variety of factors. In the end, the decision to proceed with outpatient shoulder replacement will be based on a discussion between you and your surgeon, who can also explain the risks of outpatient shoulder replacement surgery. It’s also worth noting that some insurance companies may not cover outpatient surgery either so it might be worth checking with them as well.