ArticleBMJ (Clinical research ed.)2023
Association between surgeon volume and patient outcomes after elective shoulder replacement surgery using data from the National Joint Registry and Hospital Episode Statistics for England: population based cohort study.
Article in BMJ (Clinical research ed.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 42 citations in OpenAlex.
- Implant selection and fixation in radial head arthroplasty: A qualitative analysis of surgeon decision-making.Shoulder & elbow · 2026Article
- Volume-outcome relationships for primary total elbow arthroplasty surgery in England: Analysis of the hospital episode statistics dataset.Shoulder & elbow · 2026Article
- Defining surgeon experience thresholds for the reduction in complications and revisions after shoulder arthroplasty: a meta-analysis of 332,542 patients.Journal of shoulder and elbow arthroplasty · 2026Review
- Learning from orthopaedic complications and adverse events in a district general hospital.Annals of the Royal College of Surgeons of England · 2026Article
- Osteoarthritis with an intact rotator cuff, reverse shoulder arthroplasty, or total shoulder arthroplasty? : a qualitative study of surgeon decision-making.Bone & joint open · 2026Article
- Predictors of prolonged length of stay in shoulder arthroplasty: A study using the National Joint Registry and Hospital Episode Statistics for England.Shoulder & elbow · 2026Article
- Reverse total shoulder arthroplasty is safe and effective in patients ≥90 Years old.JSES international · 2026Article
- Does computer navigation improve patient outcomes compared to conventional techniques in total shoulder arthroplasty? A single-surgeon experience.Clinics in shoulder and elbow · 2025Article
- Predictors for day case surgery in shoulder arthroplasty: a study using the National Joint Registry and Hospital Episode Statistics for England.Journal of orthopaedic surgery and research · 2025Article
- Article
- Re-revision following revision of a failed primary reverse total shoulder arthroplasty: an analysis of the National Joint Registry and Hospital Episode Statistics for England.JSES international · 2025Article
- Higher surgeon volume reduces early failure in first time revision of non-infected total knee arthroplasty: An analysis using data from the United Kingdom National Joint Registry.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Systolic blood pressure variability: risk of cardiovascular events, chronic kidney disease, dementia, and death.European heart journal · 2025Article
- Article
- What influences the surgeon's decision between anatomical and reverse total shoulder arthroplasty in primary osteoarthritis? A case-vignette study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Article
- Higher hospital volume reduces early failure rates in single-stage revision TKR for infection: An analysis of the United Kingdom National Joint Registry and National Administrative Databases.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Shoulder arthroplasty in the elderly.Journal of clinical orthopaedics and trauma · 2025Article
- Hospital length of stay, 30-day emergency readmissions and the role of the DrEaMing enhanced recovery pathways in colonic and rectal surgery in England.British journal of anaesthesia · 2025Observational
- Retrospective analysis of the occurrence, potential risk factors and medical significance of pulmonary complications after total shoulder arthroplasty from the National Inpatient Sample database (2010-2019).Perioperative medicine (London, England) · 2025Article
- Total elbow replacement in England: a protocol for analysis of National Joint Registry and Hospital Episode Statistics data.Journal of orthopaedic surgery and research · 2024Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the association between surgeon volume and patient outcomes after elective shoulder replacement surgery to improve patient outcomes and inform future resource planning for joint replacement surgery.
designProspective cohort study.
settingPublic and private hospitals in the United Kingdom, 2012-20.
participantsAdults aged 18 years or older who had shoulder replacement surgery, identified in the National Joint Registry, with linkage of participants in England to Hospital Episode Statistics data.
main outcome measuresThe main outcome measure was revision surgery. Secondary outcome measures were reoperation within 12 months, serious adverse events, and prolonged hospital stay (>3 nights) after shoulder replacement surgery.
results39 281 shoulder replacement procedures undertaken by 638 consultant surgeons at 416 surgical units met the inclusion criteria and were available for analysis. Multilevel mixed effects models and restricted cubic splines were fit to examine the association between a surgeon's mean annual volume and risk of adverse patient outcomes, with a minimum volume threshold of 10.4 procedures yearly identified. Below this threshold the risk of revision surgery was significantly increased, as much as twice that of surgeons with the lowest risk (hazard ratio 1.94, 95% confidence interval 1.27 to 2.97). A greater mean annual surgical volume was also associated with a significantly lower risk of reoperations, fewer serious adverse events, and shorter hospital stay, with no thresholds identified. Annual variation in surgeon volume was not associated with any of the outcomes assessed.
conclusionsIn the healthcare system represented by these registry data, an association was found between surgeons who averaged more than 10.4 shoulder replacements yearly and lower rates of revision surgery and reoperation, lower risk of serious adverse events, and shorter hospital stays. These findings should inform resource planning for surgical services and joint replacement surgery waiting lists and improve patient outcomes after shoulder replacement surgery.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.