Surgeon experience and procedure type are associated with intraoperative cost and efficiency in shoulder arthroplasty: a retrospective multicenter study

Q4 Medicine

Seminars in Arthroplasty Pub Date : 2026-06-01 Epub Date: 2026-01-21 DOI:10.1016/j.sart.2026.151554

Andrew M. Schmidt ME , Garrett K. Berger MD, PharmD , Rebecca L. Hill DrPH , Zimin Zhuang MS , Rebecca Gambatese MPH , Anna C. Davis PhD , Heather A. Prentice PhD , Anshuman Singh MD , Ronald A. Navarro MD

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引用次数: 0

Abstract

Background

Shoulder arthroplasty is performed with increasing frequency, which has prompted greater attention to understand the drivers of procedural cost and surgical efficiency. While surgeon experience has been linked to improved outcomes in other orthopedic domains, its association with intraoperative cost and operative time in shoulder arthroplasty is unclear. In addition, differences in intraoperative resource utilization between anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) are not well defined.

Methods

We conducted a retrospective cross-sectional study of 4,143 primary elective aTSA and rTSA procedures performed between 2018 and 2023 across 21 centers within an integrated health care system. Surgeon experience was evaluated using 3 metrics: annual case volume, total prior shoulder arthroplasties, and years in practice. Cost data were categorized as implant and supply costs, and operative time was used to assess surgical efficiency. Nine multivariable generalized linear mixed models (3 predictors × 3 outcomes) were used, adjusting for patient demographics, comorbidities, procedure type, and surgery year, with surgeon included as a random effect.

Results

Higher annual case volume (≥30 cases/y) was associated with 11% lower supply costs (P < .001) and 5% shorter operative times (P = .023). More years in practice (≥nine years) was associated with 6% shorter operative times (P < .001). Total prior arthroplasties were not associated with cost or operative time after adjustment. rTSA was associated with 36% higher implant costs, 8% lower supply costs, and 8% shorter operative times compared to aTSA (P < .001 for each).

Conclusion

Annual case volume and years in practice were associated with greater intraoperative efficiency in shoulder arthroplasty. rTSA demonstrated distinct resource utilization patterns compared to aTSA, highlighting the importance of procedure-specific benchmarking in optimizing surgical cost efficiency.

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肩关节置换术中外科医生经验和手术类型与术中成本和效率相关：一项回顾性多中心研究

肩关节置换术的实施频率越来越高，这促使人们更加关注手术成本和手术效率的驱动因素。虽然外科医生的经验与其他骨科领域的预后改善有关，但其与肩关节置换术中成本和手术时间的关系尚不清楚。此外，解剖式全肩关节置换术（aTSA）和逆行式全肩关节置换术（rTSA）在术中资源利用方面的差异并没有很好的定义。方法：我们对综合医疗保健系统内21个中心在2018年至2023年期间进行的4,143例初级选择性aTSA和rTSA手术进行了回顾性横断面研究。使用3个指标评估外科医生的经验：年病例量、既往肩关节置换术总数和实践年数。成本数据分为种植体和供应成本，手术时间用于评估手术效率。使用了9个多变量广义线性混合模型（3个预测因子× 3个结果），调整了患者人口统计学、合并症、手术类型和手术年份，其中包括外科医生作为随机效应。结果年病例量越大（≥30例/年），供应成本降低11% (P < 0.001)，手术时间缩短5% （P = 0.023）。工作年限越长（≥9年），手术时间缩短6% （P < .001）。既往关节置换术的总数与调整后的成本或手术时间无关。与aTSA相比，rTSA的种植成本高36%，供应成本低8%，手术时间短8% （P < 0.001）。结论肩关节置换术的年病例量和年数与术中效率相关。与aTSA相比，rTSA显示出不同的资源利用模式，突出了特定程序基准在优化手术成本效率方面的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Arthroplasty Medicine-Surgery

CiteScore

1.00

自引率

0.00%

发文量

104

期刊介绍： Each issue of Seminars in Arthroplasty provides a comprehensive, current overview of a single topic in arthroplasty. The journal addresses orthopedic surgeons, providing authoritative reviews with emphasis on new developments relevant to their practice.