Shoulder arthroplasty volume standards: the more the better?

Archives of Orthopaedic and Trauma Surgery
Bauke W KooistraDerek F P van Deurzen

Abstract

The wide use of hip and knee arthroplasty has led to implementation of volume standards for hospitals and surgeons. For shoulder arthroplasty, the effect of volume on outcome has been researched, but no volume standard exists. This review assessed literature reporting on shoulder arthroplasty volumes and its relation to patient-reported and functional outcomes to define an annual volume threshold. MEDLINE and EMBASE were searched for articles published until February 2018 reporting on the outcome of primary shoulder arthroplasty in relation to surgeon or hospital volume. The primary outcome was predefined as any patient-reported outcome. The secondary outcome measures were length of stay, costs, rates of mortality, complications, readmissions, and revisions. A meta-analysis was performed for outcomes reported by two or more studies. Eight retrospective studies were included and did not consistently show any associations of volume with in-hospital complications, revision, discharge to home or cost. Volume was consistently associated with length of stay (shorter length of stay for higher volume) and in-hospital complications (fewer in-hospital complications for higher volume). It was not consistently associated with mortality. Fu...Continue Reading

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Citations

Jan 25, 2020·The Journal of Bone and Joint Surgery. American Volume·Kevin X FarleyEric R Wagner

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