Patients in the study who had shoulder surgery had far less in-hospital post-surgical complications (7.5 percent) compared with those patients who had their hips and knees replaced (15.5 percent and 14.7 percent, respectively). McFarland's team also determined that the average time a person remained hospitalized after the surgery was lowest for those recovering from shoulder procedures (just 2.42 days for shoulder patients, versus more than four days for both the hip and knee equivalents).
Shoulder arthroplasty is also less expensive, according to McFarland. A shoulder replacement's total costs, on average, are $10, 351; whereas hip replacement surgery averages $15, 442, and knee arthroplasty, $14, 674.
In the study period, there were no fatalities associated with shoulder replacement, compared to 27 deaths among hip replacement patients and 54 among knee replacement patients. Given the small number of shoulder surgeries actually performed, McFarland noted that the mortality rates for the procedure were not statistically different from the other forms of arthroplasty. But finding no resulting deaths attributed to total shoulder replacement in the group of patients studied did add "clinical significance" to the idea that shoulder surgery is relatively safer. The study's authors suspect that the higher number of deaths related to hip and knee procedures may be related to repeat surgeries stemming from postoperative complications during the same hospitalization, a need for blood transfusions or extended intensive care stays.
McFarland says most patients who are candidates for total shoulder replacement surgery are "at the end of their rope" t
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Contact: Jeff Ventura
jventur4@jhmi.edu
410-955-7832
Johns Hopkins Medical Institutions
26-Mar-2007