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. 2022 Oct;14(5):534-543.
doi: 10.1177/17585732211008900. Epub 2021 Apr 24.

Trends in operative duration of total shoulder arthroplasty from 2008 to 2018: a national database study

Edward J Testa  1 , Nicholas J Lemme  1 , Lambert T Li  2 , Steven DeFroda  1
Affiliations

Trends in operative duration of total shoulder arthroplasty from 2008 to 2018: a national database study

Edward J Testa et al. Shoulder Elbow. 2022 Oct.

Abstract

Background: As total shoulder arthroplasty has emerged as the fastest growing joint replacement performed, optimizing surgical efficiency and patient outcomes is essential. The goals of the current study were to identify trends and factors affecting the operative time of total shoulder arthroplasty over a 10-year period.

Methods: The National Surgical Quality Improvement Program database was analyzed to determine the operative time and 30-day complications of total shoulder arthroplasty from 2008 to 2018. Factors affecting total shoulder arthroplasty operative time were also assessed. Multivariable linear regression was used to analyze operative time over years studied while controlling for patient demographics and comorbidities.

Results: A total of 20,587 total shoulder arthroplasty cases from 2008 to 2018 were included. Mean operative time in 2008 was 139.0 min, while in 2018, mean operative time decreased to 105.6 min (P < .001). Male sex, outpatient surgery, increased body mass index, and low preoperative hematocrit were associated with longer operative times, while elevated international normalized ratio, resident involvement, and elective surgeries were associated with decreased operative duration.

Discussion: Operative time for total shoulder arthroplasty has decreased from 2008 to 2018. Patient factors and comorbidities are associated with operative time, and such factors are important to consider in operative planning to ensure appropriate patient and surgeon expectations.

Keywords: Shoulder; arthroplasty; complications; length of stay; operative duration.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of inclusion criteria for study subjects. TSA: Total shoulder arthroplasty. rTSA: Reverse total shoulder arthroplasty. CPT: current procedural terminology; NSQIP: National Surgical Quality Improvement Program; BMI: body mass index; ASA: American Society of Anesthesia; LOS: length of stay.
Figure 2.
Figure 2.
Annual mean operative time and linear regression model of operative time based on year for total shoulder arthroplasty.
Figure 3.
Figure 3.
Annual mean length of stay and linear regression model of operative time based on year for total shoulder arthroplasty.
See this image and copyright information in PMC

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