ReviewJournal of shoulder and elbow arthroplasty2026
Defining surgeon experience thresholds for the reduction in complications and revisions after shoulder arthroplasty: a meta-analysis of 332,542 patients.
Review in Journal of shoulder and elbow arthroplasty, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
Background: Shoulder arthroplasty utilization has increased substantially, with a growing proportion of cases performed by surgeons early in the learning curve. Surgeon-volume definitions vary widely across the literature, and although higher volume is generally associated with better outcomes, there is no consensus on the thresholds that define high volume. This study aimed to determine shoulder arthroplasty cases/yr thresholds at which complication and revision risks diverge between low- and high-volume surgeons. Methods: PubMed, Cochrane, and Google Scholar were queried through December 2025. Inclusion criteria consisted of comparative studies evaluating the number of complications and revisions after shoulder arthroplasty across different categories of surgeon experience. Five different thresholds of cases/yr were established to perform the analysis and define high- and low-volume surgeons: 5 cases/yr, 10 cases/yr, 14 cases/yr, 20 cases/yr, and 25-28 cases/yr. Results: Eight studies with 332,542 patients were included. At the 5 cases/yr threshold, low-volume surgeons had higher odds of complications (odds ratio [OR] = 1.41; 95% confidence interval [CI], 1.28-1.55; Conclusion: This study identified surgeon-volume thresholds for shoulder arthroplasty of 5 cases/yr and 25-28 cases/yr, which may possibly define low-to-medium and medium-to-high-volume thresholds, respectively. Patients treated by surgeons below these thresholds had higher risks of complications and revision compared with those treated by surgeons above the respective thresholds.
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