Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Nov 2016
Outpatient total shoulder arthroplasty: a population-based study comparing adverse event and readmission rates to inpatient total shoulder arthroplasty.
The rate of total shoulder arthroplasty (TSA) is rising, which has an impact on health care expenditure. One avenue to mitigate cost is outpatient TSA. There are currently no published reports of this practice. In this study, we determine the 30-day adverse event and readmission rates after outpatient TSA and compare these rates with inpatient TSA. ⋯ There are no significant differences in the 30-day adverse event and readmission rates between outpatient and inpatient TSA. In the appropriately selected patient, outpatient TSA is safe and cost-effective.
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J Shoulder Elbow Surg · Nov 2016
Randomized Controlled TrialLiposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: a prospective randomized trial.
Our hypothesis was that in patients undergoing shoulder arthroplasty, a prospective randomized trial would find no significant differences in average daily pain scores of those treated with interscalene nerve block (INB) vs. local liposomal bupivacaine (LB). ⋯ An increase in early postoperative pain on the day of surgery was found with LB, whereas the INB group required more narcotics at the end of the day. After the day of surgery, there were no significant differences found in any variables. These findings suggest that LB provides similar overall pain relief as INB, with no increase in complications or length of stay and a decrease in narcotic requirements on the day of surgery.
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J Shoulder Elbow Surg · Nov 2016
Intra-articular lesions and their relation to arthroscopic stabilization failure in young patients with first-time and recurrent shoulder dislocations.
This study aimed to compare the frequency of intra-articular lesions between young patients with first-time shoulder dislocations and those with recurrent shoulder dislocations and to assess the correlation between intra-articular lesions and failure of arthroscopic stabilization. ⋯ Primary surgical treatment for first-time traumatic anterior shoulder dislocation provided satisfactory functional outcomes and improved quality of life. Primary arthroscopic stabilization can be considered one of the treatment options in patients younger than 30 years with first-time shoulder dislocation to prevent further intra-articular injuries that may contribute to recurrence.