Same Day Shoulder Surgery
Same Day Shoulder Surgery is a procedure that does not require an overnight hospital stay. The procedure is for all arthroscopy surgeries and for shoulder replacements in patients under the age of 70. Your doctor may consider same day shoulder surgery if you have severe pain which limits daily activities and is not relieved with medications, injections, physical therapy, or other treatments. The goal of the surgery is to relieve pain and restore the alignment and function of your joint.
Traditionally, shoulder surgery has been an inpatient surgical procedure. With the introduction of minimally invasive techniques, modern pain protocols, improved anesthetic techniques, and rapid rehabilitation protocols surgeons are able to perform shoulder surgery on an outpatient basis. With same day shoulder surgery the patient is allowed to go home in the first 24 hours after the surgery. This allows patients to recover at home instead of overnight in a hospital. When a patient goes home the day of surgery Dr. Denard calls the patient that evening to check on them. In addition, an on-call physician is available 24 hours a day. Physical therapy begins at home the day after surgery with home exercises specific for each patient and outlined in an individualized rehabilitation plan.
Not everyone requires or qualifies for same day shoulder surgery. However, for selected patients, same day shoulder surgery is a reality and preferable. To be considered for same day shoulder surgery, a person should be in good health, have a high level of motivation during the rehabilitation process and good family support.
The benefits of same day shoulder surgery over inpatient shoulder surgery include the following:
- Decreased hospital stay
- Improved pain management protocols
- Early mobilization
- Rapid recovery
- Careful home monitoring
- Fewer complications
- Improved outcomes
- Increased patient satisfaction
Same Day Shoulder Replacement FAQs
Who is a candidate?
Several factors are used to determine appropriate candidates for same day surgery. These include age (under 80 years old), patients in good health and if the patient has at-home assistance, like a spouse, friend or family member.
Where is the surgery performed?
For patients with standard or “commercial” insurance the surgery is performed at an outpatient or ambulatory surgery center. The first benefit of performing the procedure at a surgery center is that the cost is much lower. Typically, the cost is one-half to one-third of the cost at a hospital. Second, the other patients at the surgery center are also in good health so the risk of “hospital-acquired” infection is lower.
For patients with Medicare insurance (typically over the age of 65) the surgery is performed as the hospital because of current Medicare billing requirements. However, a patient can still go home the same day.
How is pain managed?
Prior to surgery pain medications are given to reduce the onset of pain. Additionally, a nerve block is commonly performed which completely numbs the shoulder for 12-18 hours after surgery. A local anesthetic is used during surgery. After surgery a combination of pain medications are used designed to reach different pain pathways in the body. With this approach, most patients require less than 20 narcotic pain pills after surgery, and 90% of patients are off of narcotic pain medications within 2 weeks post-operatively.
How long is the surgery?
With a minimally invasive approach, the surgical time can be reduced to an hour or less. The surgical time is reduced by using preoperative planning (so that the surgery is virtually performed prior to the actual procedure) and having a consistent team that knows the procedure well.
What are the benefits of same day shoulder replacement?
- Lower rate of complication - Studies have shown that same day shoulder replacement is safe and possible has a lower rate of complication compared to staying in the hospital. The reason for this is that there are many patients in a hospital who are sick. This leads to the possibility of hospital-acquired infection.
- Recover in the comfort of your home - Hospitals tend to less comfortable. They are noisy and often rooms have to be shared with other patients. A healthy individual is better off recovering in their own home.
- Reduced cost - The procedure costs less at a surgery center. For people with high-deductible plans or those who have to share a percentage of the cost, this can lead to thousands of dollars of savings.