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Ambulatory Surgical Centers: A Review of Complications and Adverse Events

Goldfarb, Charles A. MD; Bansal, Anchal BS; Brophy, Robert H. MD

Journal of the American Academy of Orthopaedic Surgeons: January 2017 - Volume 25 - Issue 1 - p 12–22
doi: 10.5435/JAAOS-D-15-00632
Review Article

An increasing number of orthopaedic surgeries are performed at ambulatory surgical centers (ASCs), as is exemplified by the 272% population-adjusted increase in outpatient rotator cuff repairs from 1996 to 2006. Outpatient surgery is convenient for patients and cost effective for the healthcare system. The rate of complications and adverse events following orthopaedic surgeries at ASCs ranges from 0.05% to 20%. The most common complications are pain and nausea, followed by infection, impaired healing, and bleeding; these are affected by surgical and patient risk factors. The most important surgeon-controlled factors are surgical time, type of anesthesia, and site of surgery, whereas the key patient comorbidities are advanced age, female sex, diabetes mellitus, smoking status, and high body mass index. As the use of ASCs continues to rise, an understanding of risk factors and outcomes becomes increasingly important to guide indications for and management of orthopaedic surgery in the outpatient setting.

From the Department of Orthopaedics, Washington University School of Medicine, St. Louis, MO.

Dr. Goldfarb or an immediate family member serves as a paid consultant to Arthrex and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and the American Society for Surgery of the Hand. Dr. Brophy or an immediate family member has stock or stock options held in Ostesys and serves as a board member, owner, officer, or committee member of the American Orthopaedic Association, the American Orthopaedic Society for Sports Medicine, and the Orthopaedic Research Society. Neither Ms. Bansal nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

Received November 03, 2015

Accepted March 25, 2016

© 2017 by American Academy of Orthopaedic Surgeons
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