Comparative learning curves for early complications in anatomical and reverse shoulder arthroplasty.

2.50
Hdl Handle:
http://hdl.handle.net/11287/620713
Title:
Comparative learning curves for early complications in anatomical and reverse shoulder arthroplasty.
Authors:
Beazley, James C.; Evans, Jonathan P. ( 0000-0003-0090-1012 ) ; Furness, N; Smith, Christopher D.
Abstract:
Introduction There has been a significant increase in the implantation of reverse shoulder replacements over anatomical shoulder replacements in the past five years. Few comparative data exist comparing early complication rates and learning curves. This study aimed to evaluate the early complication rates and learning curves of a single surgeon series of anatomical and reverse shoulder replacements over the first five years of independent practice. Materials and methods The first 100 anatomical and 100 reverse shoulder replacements performed between July 2011 and July 2016 were reviewed to identify early complications. Cumulative sum plots were used to analyse the learning-curve effect. Results Early complications were noted in 4 anatomical and 17 reverse shoulder replacements. One of the anatomical and ten of the reverse shoulder replacements required a return to theatre within three months. The early complication rates were observed to be significantly higher in the reverse shoulder replacement group compared with the anatomical shoulder replacement group (odds ratio 4.9; 95% confidence interval 1.6-15.2, P 1/4 0.057). An inflection point on the anatomical shoulder replacement cumulative sum plot suggestive of a trend to consistent performance was reached at 16 cases. No inflection point was observed on the reverse shoulder replacement cohort. Conclusions We observed a significantly higher early complication rate within the reverse shoulder replacement cohort, with a tenfold increase in early reoperations. In comparison to the trend seen after 16 cases for anatomical shoulder replacement, no trend was seen in the reverse shoulder replacement cohort. This either reflects the higher complication rate seen in reverse shoulder replacement or that the learning curve extends beyond 100 cases, highlighting the need for extended performance monitoring.
Citation:
Comparative learning curves for early complications in anatomical and reverse shoulder arthroplasty. 2018 Jul;100(6):491-496 Ann R Coll Surg Engl
Publisher:
Royal College of Surgeons
Journal:
Annals of the Royal College of Surgeons of England
Issue Date:
25-Apr-2018
URI:
http://hdl.handle.net/11287/620713
DOI:
10.1308/rcsann.2018.0062
PubMed ID:
29692187
Additional Links:
http://publishing.rcseng.ac.uk/doi/abs/10.1308/rcsann.2018.0062?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Type:
Journal Article
Language:
en
ISSN:
1478-7083
Appears in Collections:
General Trauma & Orthopaedics; 2018 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBeazley, James C.en
dc.contributor.authorEvans, Jonathan P.en
dc.contributor.authorFurness, Nen
dc.contributor.authorSmith, Christopher D.en
dc.date.accessioned2018-06-20T15:33:38Z-
dc.date.available2018-06-20T15:33:38Z-
dc.date.issued2018-04-25-
dc.identifier.citationComparative learning curves for early complications in anatomical and reverse shoulder arthroplasty. 2018 Jul;100(6):491-496 Ann R Coll Surg Englen
dc.identifier.issn1478-7083-
dc.identifier.pmid29692187-
dc.identifier.doi10.1308/rcsann.2018.0062-
dc.identifier.urihttp://hdl.handle.net/11287/620713-
dc.description.abstractIntroduction There has been a significant increase in the implantation of reverse shoulder replacements over anatomical shoulder replacements in the past five years. Few comparative data exist comparing early complication rates and learning curves. This study aimed to evaluate the early complication rates and learning curves of a single surgeon series of anatomical and reverse shoulder replacements over the first five years of independent practice. Materials and methods The first 100 anatomical and 100 reverse shoulder replacements performed between July 2011 and July 2016 were reviewed to identify early complications. Cumulative sum plots were used to analyse the learning-curve effect. Results Early complications were noted in 4 anatomical and 17 reverse shoulder replacements. One of the anatomical and ten of the reverse shoulder replacements required a return to theatre within three months. The early complication rates were observed to be significantly higher in the reverse shoulder replacement group compared with the anatomical shoulder replacement group (odds ratio 4.9; 95% confidence interval 1.6-15.2, P 1/4 0.057). An inflection point on the anatomical shoulder replacement cumulative sum plot suggestive of a trend to consistent performance was reached at 16 cases. No inflection point was observed on the reverse shoulder replacement cohort. Conclusions We observed a significantly higher early complication rate within the reverse shoulder replacement cohort, with a tenfold increase in early reoperations. In comparison to the trend seen after 16 cases for anatomical shoulder replacement, no trend was seen in the reverse shoulder replacement cohort. This either reflects the higher complication rate seen in reverse shoulder replacement or that the learning curve extends beyond 100 cases, highlighting the need for extended performance monitoring.en
dc.language.isoenen
dc.publisherRoyal College of Surgeonsen
dc.relation.urlhttp://publishing.rcseng.ac.uk/doi/abs/10.1308/rcsann.2018.0062?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmeden
dc.rightsArchived with thanks to Annals of the Royal College of Surgeons of Englanden
dc.subjectWessex Classification Subject Headings::Orthopaedicsen
dc.titleComparative learning curves for early complications in anatomical and reverse shoulder arthroplasty.en
dc.typeJournal Articleen
dc.identifier.journalAnnals of the Royal College of Surgeons of Englanden
dc.type.versionPublisheden

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