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. 2024 Oct 14;8(10):e24.00117.
doi: 10.5435/JAAOSGlobal-D-24-00117. eCollection 2024 Oct 1.

After Primary Total Shoulder Arthroplasty, Factors Associated with Returning to the Same Surgeon for Subsequent Total Shoulder Arthroplasty

Michael J Gouzoulis  1 , Scott J Halperin, Anthony E Seddio, Christopher Wilhelm, Jay Moran, Kenneth W Donohue, Andrew E Jimenez, Jonathan N Grauer
Affiliations

After Primary Total Shoulder Arthroplasty, Factors Associated with Returning to the Same Surgeon for Subsequent Total Shoulder Arthroplasty

Michael J Gouzoulis et al. J Am Acad Orthop Surg Glob Res Rev. .

Abstract

Background: Total shoulder arthroplasty (TSA) is commonly done for degenerative conditions. Patients may need additional contralateral TSA or ipsilateral revision TSA. As a marker of patient satisfaction and practice integrity, factors associated with return to the same or different surgeon are of interest.

Methods: Patients undergoing TSA were abstracted from the PearlDiver data set. Subsequent TSA within 2 years was identified. Factors analyzed included age, sex, comorbidity burden, prior depression diagnosis, insurance type, reverse versus anatomic TSA, ipsilateral versus contralateral surgery, and postoperative adverse events. Patients returning to the same surgeon versus different surgeon were compared with multivariable analysis.

Results: 98,048 TSA patients were identified, with 8483 patients (8.7%) undergoing subsequent TSA within 2 years. Of those, 1,237 (14.6%) chose a different surgeon. Factors associated with changing surgeons were revision surgery on the ipsilateral shoulder (OR:2.47), Medicaid insurance (OR:1.46), female sex (OR:1.36), any adverse events (OR:1.23), and higher Elixhauser Comorbidity Index (OR:1.07 per point), while prior depression diagnosis was associated with decreased odds (OR:0.74) of changing surgeon (P < 0.05 for all).

Discussion: When pursuing a subsequent TSA, only a minority of patients changed to a different surgeon. Factors identified associated with changing to a different surgeon may help guide measures to improve patient satisfaction and practice integrity.

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Conflict of interest statement

None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Mr. Gouzoulis, Dr. Halperin, Mr. Seddio, Dr. Wilhelm, Dr. Moran, Dr. Donohue, Dr. Jimenez, and Dr. Grauer

Figures

Figure 1
Figure 1
A pie chart showing all patients who underwent total shoulder arthroplasty (TSA) and how many underwent a subsequent TSA within 2 years. A subplot is shown dividing patients based on whether they returned to same surgeon or changed to a different surgeon for their subsequent surgery.
Figure 2
Figure 2
Forest plot showing odds ratio and 95% confidence intervals of changing surgeons for subsequent TSAs.
See this image and copyright information in PMC

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