Abstract
BACKGROUND: Elective shoulder arthroplasty waiting list times are increasing. Day case shoulder arthroplasty (DCSA) could help address this. This study aimed to review the safety, cost savings and patient satisfaction of a DCSA pathway introduced in May 2021. METHODS: All elective shoulder arthroplasties over three years (May 2021-2024) at a single centre were prospectively collected and retrospectively analysed. Two cohorts were compared: DCSA and inpatient. Primary outcomes were 90-day readmission and complication rates. Secondary outcomes were estimated cost savings and patient satisfaction using a locally developed non-validated questionnaire. RESULTS: Of 102 shoulder arthroplasties, 25 were DCSA and 77 were inpatients. DCSA patients were significantly younger (mean age 64.8 vs. 73.6 years; p < 0.001) and more likely to have ASA I status (16% vs. 6%; odds ratio (OR) 2.74, 95% confidence interval (CI) 0.68-11.14; p = 0.04). There were no significant differences in 90-day complications (4% vs. 9%; OR 0.42, 95% CI 0.05-3.56; p = 0.42) or readmissions (0% vs. 2%; OR 0.42, 95% CI 0.05-3.56; p = 1.00). All DCSA patients reported treatment success and were six times more likely to recommend it. Estimated cost savings were £10,262.75, with £37,766.92 potentially saved if all patients had undergone DCSA. CONCLUSION: DCSA is safe, cost saving, and has high patient satisfaction. DCSA could be more widely adopted across the UK.