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Zmistowski B, Warrender W, Livesey M, et al. The Characteristics of Surgeons Performing Total Shoulder Arthroplasty: Volume Consistency, Training, and Specialization. Am J Orthop (Belle Mead NJ). 2018;47(12)doi: 10.12788/ajo.2018.0111.
Zmistowski, B., Warrender, W., Livesey, M., Girden, A., Williams, G. R., & Namdari, S. (2018). The Characteristics of Surgeons Performing Total Shoulder Arthroplasty: Volume Consistency, Training, and Specialization. American journal of orthopedics (Belle Mead, N.J.), 47(12), . https://doi.org/10.12788/ajo.2018.0111
Zmistowski, Benjamin, et al. "The Characteristics of Surgeons Performing Total Shoulder Arthroplasty: Volume Consistency, Training, and Specialization." American journal of orthopedics (Belle Mead, N.J.) vol. 47,12 (2018). doi: https://doi.org/10.12788/ajo.2018.0111
Zmistowski B, Warrender W, Livesey M, Girden A, Williams GR, Namdari S. The Characteristics of Surgeons Performing Total Shoulder Arthroplasty: Volume Consistency, Training, and Specialization. Am J Orthop (Belle Mead NJ). 2018 Dec;47(12). doi: 10.12788/ajo.2018.0111. PMID: 30650175.
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Am J Orthop (Belle Mead NJ). 2018 Dec;47(12). doi: 10.12788/ajo.2018.0111.

The Characteristics of Surgeons Performing Total Shoulder Arthroplasty: Volume Consistency, Training, and Specialization.

American journal of orthopedics (Belle Mead, N.J.)

Benjamin Zmistowski, William Warrender, Michael Livesey, Alex Girden, Gerald R Williams, Surena Namdari

Affiliations

  1. Rothman Orthopaedic Institute, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA. Email: [email protected].

PMID: 30650175 DOI: 10.12788/ajo.2018.0111

Abstract

Total shoulder arthroplasty (TSA) has proved a cost-effective, reproducible procedure for multiple shoulder pathologies. As utilization of TSA continues to grow, it is important to investigate procedure diversity, training, and other characteristics of surgeons performing TSA. To identify surgeons performing TSA in the Medicare population, the Medicare Provider Utilization and Payment Databases from 2012 through 2014 were used. This dataset includes any provider who bills Medicare >10 times with a single billing code. A web-based search was performed for each physician performing >10 TSA in all years of the study to identify their surgical training characteristics. Between 2012 and 2014, 1374 surgeons (39 females [2.8%]) performed >10 TSA in Medicare patients in at least 1 year (71,973 TSA). Only 44.3% (609/1374) of surgeons met this threshold for all 3 years (55,538 TSA). Of these 609 surgeons, 191 (31.3%) were shoulder and elbow fellowship trained (21,444 TSA). Shoulder and elbow fellowship-trained surgeons were at earlier points in their careers and practiced in large referral-based centers with other surgeons performing TSA. In addition to TSA, surgeons performed other non-arthroplasty shoulder procedures (80.2% of surgeons), total knee arthroplasty (46.3%), repairs of traumatic injuries (29.8%), total hip arthroplasty (27.8%), non-arthroplasty knee surgeries (27.2%), elbow procedures (19.6%), and hand surgery (15.4%) during the study period. With less than one-third of TSA performed by shoulder and elbow fellowship-trained surgeons with consistent moderate-volume practices, the impact of consistent high-volume practices and targeted fellowship training on quality must be determined.

Conflict of interest statement

Authors' Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.

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