Operative duration-based learning period analysis for reverse and total shoulder arthroplasty: A multicenter study.

Area of Science:

• Orthopedic Surgery
• Surgical Education
• Biostatistics

Background:

• Quantifying the learning period is crucial for surgical training.
• Operative duration decreases significantly after a surgeon gains experience.

Purpose of the Study:

• To retrospectively quantify and compare the learning experience of surgeons performing total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA).

Main Methods:

• A retrospective review of 2055 TSA and RSA cases (2011-2015) from eight fellowship-trained shoulder surgeons.
• Operative time was plotted against consecutive case number and annual volume.
• A two-step regression analysis identified the learning curve plateau point.

Main Results:

• Early-career surgeons showed significant operative time reduction with increased case volume for both TSA (p=0.02) and RSA (p=0.01).
• Three of four early-career surgeons reached a plateau between 12 and 86 cases.
• Improvement in operative time was more pronounced for RSA compared to TSA.

Conclusions:

• Higher case volume leads to decreased operative duration in early-career surgeons.
• The learning period for shoulder arthroplasty can be less than 90 cases.
• RSA demonstrates a steeper learning curve and faster improvement than TSA.