Evidence map›Paper›PMID 39499293›Full record

SynthesisInternational orthopaedics2025

Outpatient versus inpatient total shoulder arthroplasty: A meta-analysis of clinical outcomes and adverse events.

Mohammad Daher, Oscar Cobvarrubias, Peter Boufadel, Mohamad Y Fares, Daniel E Goltz, Adam Z Khan, John G Horneff, Joseph A Abboud

Abstract readComparative StudyMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mohammad DaherRothman Institute, Thomas Jefferson Medical Center, Philadelphia, PA, USA. mohdaher1@hotmail.com.ORCID 0000-0002-9256-9952
Oscar CobvarrubiasDepartment of Orthopaedic Surgery, Brown University, Providence, RI, USA.
Peter BoufadelRothman Institute, Thomas Jefferson Medical Center, Philadelphia, PA, USA.
Mohamad Y FaresRothman Institute, Thomas Jefferson Medical Center, Philadelphia, PA, USA.
Daniel E GoltzRothman Institute, Thomas Jefferson Medical Center, Philadelphia, PA, USA.
Adam Z KhanDepartment of Orthopaedic Surgery, Southern California Permanente Medical Group, Panorama City, CA, USA.
John G HorneffDivision of Shoulder and Elbow Surgery, Department of Orthopaedics, University of Pennsylvania, Philadelphia, PA, USA.
Joseph A AbboudRothman Institute, Thomas Jefferson Medical Center, Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn recent years, orthopaedic procedures have increasingly shifted from inpatient to outpatient settings. This trend includes total shoulder arthroplasty (TSA), which is being performed more frequently in outpatient facilities and ambulatory surgical centres. The purpose of this study was to compare the clinical outcomes and rates of adverse events between outpatient and inpatient TSA.

methodsPubMed, Cochrane, and Google Scholar (pages 1-20) databases were screened for articles comparing outpatient to inpatient TSA through June 2024, using relevant and holistic search terms. Non-comparative articles and those utilizing national databases were excluded from our study. Data on complications, myocardial infarction (MI), thromboembolic events, anaemia/transfusions, infections, readmissions, emergency department (ED) visits, revision surgery, and patient reported outcome measures at one year (Visual Analog Scale [VAS] and American Shoulder and Elbow Surgeons [ASES] score) were extracted.

resultsA total of 14 articles were included in our study, involving 1070 outpatient and 1330 inpatient TSA patients. Patients in the inpatient group were older and had a higher ASA compared to the patients in the outpatient group. The outpatient TSA group was found to have significantly lower rates of overall complications (odds ratio [OR] = 0.59, p = 0.001), medical complications (OR = 0.43, p < 0.001), and readmissions (OR = 0.47, p = 0.008), as well as higher mean ASES scores (81.4 vs. 78.5, p = 0.01) when compared to the inpatient TSA group. There were no significant differences in rates of ED visits (p = 0.27), revisions (p = 0.06), and VAS scores (p = 0.15) between inpatient and outpatient TSA groups.

conclusionTSAs performed in the outpatient setting had a lower rate of overall adverse events, medical complications, readmissions, and a higher ASES score compared to inpatient TSAs. However, since patients in the inpatient group had higher ASA and were older, our results support the safety of the outpatient TSA based on the current selection criteria.

Indexed as

Ambulatory Surgical ProceduresArthroplasty, Replacement, ShoulderPostoperative ComplicationsHumansInpatientsOutpatientsPatient ReadmissionTreatment OutcomeAnatomic shoulder arthroplastyComplicationsInpatientOutpatientReverse shoulder arthroplastyTotal shoulder arthroplasty

Identifiers

PMID39499293

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.