**1. Introduction**

The coronavirus (COVID-19) pandemic caused drastic disruptions to the provision of elective orthopedic surgery services in the United States [1]. This crisis also presented an opportunity for value optimization by promoting collaboration and creative thinking. One well-documented disruptive change has been the swift adoption of telehealth services [2,3]. The COVID outbreak may have also catalyzed the shift towards more resource-efficient outpatient joint arthroplasty, but this remains speculation [4].

Elective shoulder arthroplasty is an increasingly popular and highly standardized procedure that has been classically performed as inpatient [5–7]. It is unclear whether COVID has changed any of this. Patients may now be more inclined to go home shortly after surgery to minimize risk of contagion [8], and to rely more on technology (e.g., email, telehealth) to address postoperative concerns that would traditionally warrant a visit to the emergency department (ED). Hospitals may also be incentivized to more expeditiously discharge elective surgery patients to ensure continued bed capacity for potential COVID surges.

This study sought to determine the impact of the COVID-19 pandemic on length of stay (LOS) and same-day discharge rates after elective total shoulder arthroplasty.

**Citation:** Menendez, M.E.; Keegan, N.; Werner, B.C.; Denard, P.J. COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty. *J. Clin. Med.* **2021**, *10*, 5908. https://doi.org/ 10.3390/jcm10245908

Academic Editors: Markus Scheibel, Alexandre Lädermann and Laurent Audigé

Received: 8 November 2021 Accepted: 15 December 2021 Published: 16 December 2021

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**Copyright:** © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

Additionally, we examined discharge disposition patterns, ED visits, readmissions and reoperations. The hypothesis was that LOS decreased post-COVID, despite no change in patient characteristics.
