Same-day shoulder surgery and shoulder replacement

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.

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 at the hospital because of current Medicare billing requirements. However, a patient can still go home the same day.

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.

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.

Lower rate of complication – Studies have shown that same day shoulder replacement is safe and possibly 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 be 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.