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. 2025 Oct 30;6(1):100609.
doi: 10.1016/j.xrrt.2025.100609. eCollection 2026 Feb.

All-cause cancellation of primary total shoulder arthroplasty at a single institution: prevalence, reasons and risk factors

Vishal Shankar  1 , Cameron Smith  1 , Savino Stallone  2 , Yungtai Lo  3 , Elilary Montilla  4 , Konrad I Gruson  2
Affiliations

All-cause cancellation of primary total shoulder arthroplasty at a single institution: prevalence, reasons and risk factors

Vishal Shankar et al. JSES Rev Rep Tech. .

Abstract

Background: Cancellation of elective total shoulder arthroplasty (TSA), particularly those occurring on or just before the surgical date, results in disruption to the surgeon's schedule and operating room flow with resulting negative financial implications. The prevalence and risk factors for all-cause cancellations remain poorly defined.

Methods: A retrospective review of an institutional database was performed to identify all-cause cancellations of primary TSA from January 2016 through December 2024. Patient demographics and surgical data, including age, insurance type, distance from home-to-clinic, socioeconomic status based on the Area Deprivation Index and arthroplasty type was tabulated. The time from booking and cancellation to planned arthroplasty, and reason for cancellation, in addition to whether the surgery was rescheduled and ultimately performed, was documented.

Results: There were 489 total cases booked during the study period by a single surgeon, of which 127 (25.9%) were canceled prior to the surgical date. There were 225 anatomic and 264 reverse TSAs, and 318 (65%) patients were female. Of the cancellations, 50 (39.4%) rescheduled and underwent TSA at a median of 98 days (interquartile range 47,238) later. A longer time between booking and planned surgery (OR 1.01, 95% confidence interval (CI) 1.001-1.02, P = .012) and presentation to the emergency department for any reason within 1 year prior to planned surgery were significantly associated with cancellation. Among cancellations, patient-driven cancellations (OR 3.74, 95% CI 1.45-9.60, P = .008) were associated with a significantly higher likelihood of not rescheduling surgery, whereas being married was associated with a decreased risk for not rescheduling (OR 0.36, 95% CI 0.15-0.84, P = .018).

Discussion: Identification of the factors associated with cancellation of elective TSA may serve as the basis for developing preoperative interventions aimed specifically at those more likely to cancel.

Keywords: Area Deprivation index; Medical optimization; Patient-driven cancellation; Surgical cancellation; Total shoulder replacement.

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References

    1. Al Talalwah N., McIltrot K.H. Cancellation of surgeries: integrative review. J Perianesth Nurs. 2019;34:86–96. doi: 10.1016/j.jopan.2017.09.012. - DOI - PubMed
    1. Caesar U., Karlsson J., Olsson L.E., Samuelsson K., Hansson-Olofsson E. Incidence and root causes of cancellations for elective orthopaedic procedures: a single center experience of 17,625 consecutive cases. Patient Saf Surg. 2014;8:24. doi: 10.1186/1754-9493-8-24. - DOI - PMC - PubMed
    1. Furtado R., MacDermid J.C., Bryant D., Faber K.J., Drosdowech D.S., Athwal G.S. Balancing clinician and patient priorities for total shoulder replacement preoperative education programs. Patient Educ Couns. 2023;112 doi: 10.1016/j.pec.2023.107759. - DOI - PubMed
    1. Kim J.H., Myerson C.L., Romero B.A., Glaser D.L., Kuntz A.F., Horneff J.G. Day of surgery cancellation in total shoulder arthroplasty: an analysis of surgical cancellation etiologies. Semin Arthroplasty. 2023;33:218–223. doi: 10.1053/j.sart.2022.10.006. - DOI
    1. Kim K., Chin G., Moore T., Schwarzkopf R. Does a preoperative educational class increase patient compliance. Geriatr Orthop Surg Rehabil. 2015;6:153–156. doi: 10.1177/2151458515580641. - DOI - PMC - PubMed

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