How does surgeon volume relate to the result of shoulder joint replacement?

The question often arises, ‘how important is surgeon experience in the outcome of surgical procedures, such as shoulder arthroplasty?” The evidence is that a high percentage of shoulder joint replacements are performed by surgeons who perform only a very few of these procedures each year and that the complication rates are higher for low volume surgeons than for high volume surgeons. For those interested the relevant references are listed below.

Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL. Surgeon volume and operative mortality in the United States. N Engl J Med 2003;349:2117-27.

Hammond JW, Queale WS, Kim TK, McFarland EG. Surgeon experience and clinical and economic outcomes for shoulder arthroplasty J Bone Joint Surg Am 2003;85:2318-24.

Hasan SS, Leith JM, Smith KL, Matsen FA 3rd. The distribution of shoulder replacement among surgeons and hospitals is significantly different than that of hip or knee replacement. J Shoulder Elbow Surg 2003;12:164-9. 

Jain N, Pietrobon R, Hocker S, Guller U, Shankar A, Higgins LD. The relationship between surgeon and hospital volume and outcomes forshoulder arthroplasty. J Bone Joint Surg Am 2004;86:496-505.

Katz JN, Losina E, Barrett J, Phillips CB, Mahomed NN, Lew RA, et al. Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States medicare population. J Bone Joint Surg Am 2001;83:1622-9.


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