Related Experiment Video
Updated: Feb 6, 2026
10:10
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
44.0K
Shoulder arthroplasty volume standards: the more the better?
Bauke W Kooistra1, Mark Flipsen2, Michel P J van den Bekerom2
1Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. bwkooistra@gmail.com.
Archives of Orthopaedic and Trauma Surgery
|August 31, 2018
Summary
Current evidence does not support volume standards for shoulder arthroplasty. Higher surgical volumes correlate with shorter hospital stays and fewer complications, but not necessarily better patient outcomes.
Area of Science:
- Orthopedic Surgery
- Health Services Research
Background:
- Hip and knee arthroplasty utilize volume standards for hospitals and surgeons.
- Shoulder arthroplasty lacks established volume standards despite research into volume-outcome relationships.
Purpose of the Study:
- To review literature on shoulder arthroplasty volumes and their association with patient-reported and functional outcomes.
- To define a potential annual volume threshold for shoulder arthroplasty.
Main Methods:
- Systematic literature search of MEDLINE and EMBASE up to February 2018.
- Included retrospective studies on primary shoulder arthroplasty outcomes related to surgeon or hospital volume.
- Performed meta-analysis for outcomes reported in multiple studies, focusing on patient-reported outcomes, length of stay, costs, mortality, complications, readmissions, and revisions.
Main Results:
- Eight retrospective studies were analyzed.
- No consistent association found between volume and in-hospital complications, revision rates, discharge destination, or cost.
- Higher surgical volumes consistently correlated with shorter length of stay and fewer in-hospital complications.
- Mortality association with volume was inconsistent; functional outcomes were not reported.
Conclusions:
- Insufficient evidence exists to establish volume standards for shoulder arthroplasty based on patient-reported or functional outcomes.
- Current proposed volume thresholds are primarily based on short-term metrics like hospital stay duration and cost.
Related Concept Videos
01:23Muscles of the Shoulder
9.2K
The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, and...
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, and...
9.2K
02:37Standard Enthalpy of Formation
49.3K
Enthalpy changes are typically tabulated for reactions in which both the reactants and products are at the same conditions. A standard state is a commonly accepted set of conditions used as a reference point for the determination of properties under other different conditions. For chemists, the IUPAC standard state refers to materials under a pressure of 1 bar and solutions at 1 M and does not specify a temperature. Many thermochemical tables list values with a standard state of 1 atm. Because...
49.3K
02:41Constant Volume Calorimetry
30.8K
Calorimeters are useful to determine the heat released or absorbed by a chemical reaction. Coffee cup calorimeters are designed to operate at constant (atmospheric) pressure and are convenient to measure heat flow (or enthalpy change) accompanying processes that occur in solution at constant pressure. A different type of calorimeter that operates at constant volume, colloquially known as a bomb calorimeter, is used to measure the energy produced by reactions that yield large amounts of heat and...
30.8K
03:02Standard Electrode Potentials
50.4K
On comparing the reactivity of silver and lead, it is observed that the two ionic species, Ag+ (aq) and Pb2+ (aq), show a difference in their redox reactivity towards copper: the silver ion undergoes spontaneous reduction, while the lead ion does not. This relative redox activity can be easily quantified in electrochemical cells by a property called cell potential. This property is commonly known as cell voltage in electrochemistry, and it is a measure of the energy which accompanies the charge...
50.4K
01:20Volume of Distribution
1.3K
The apparent volume of distribution (Vd) is a crucial pharmacokinetic parameter representing the hypothetical body fluid volume into which a drug disperses. It is calculated based on the total amount of drug in the body (estimated from the administered dose and bioavailability) divided by the plasma drug concentration. The total amount of drug in the body does not directly refer to the dose given but is derived by accounting for absorption, distribution, metabolism, and excretion processes.
1.3K
03:38Measurement: Standard Units
80.9K
Every measurement provides three kinds of information: the size or magnitude of the measurement (a number), a standard of comparison for the measurement (a unit), and an indication of the uncertainty of the measurement. While the number and unit are explicitly represented when a quantity is written, the uncertainty is an aspect of the errors in the measurement results.
80.9K