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Future Demand for Total Joint Arthroplasty Drives Renewed Interest in Arthroplasty Fellowship

  • Matthew SloanEmail author
  • Ajay Premkumar
  • Neil P. Sheth
Original Article
  • 3 Downloads

Abstract

Background

Total joint arthroplasty (TJA) procedure volume has increased continuously in the USA, but prior reports have suggested that orthopedic surgeon supply may not meet future demand due to retirement and waning interest in arthroplasty fellowships.

Purposes

We sought to evaluate trends in growth in the number of orthopedic surgeons, orthopedic residents, and arthroplasty fellowships, in order to predict changes in future TJA procedure volume per surgeon.

Methods

We retrospectively reviewed data from 1995 to 2017 from the American Academy of Orthopaedic Surgeons, the National Residency Matching Program, American Osteopathic Association Residency Match, the San Francisco Match, and the National Inpatient Sample. Annual volume growth in the rate of TJA procedures and in orthopedic surgeons, residents, and fellows was determined.

Results

TJA procedure volume increased 129%, orthopedic surgeon volume increased 15.6%, and orthopedic resident volume increased 29.4%. The percentage of filled arthroplasty fellowship positions increased from 81.9 to 96.4%, and the number of arthroplasty fellowship positions increased 33.5%. Mean surgeon age increased from 50.9 to 56.5 years. By 2030, we estimate 90.1 TJA procedures per surgeon will be performed annually, a 57% increase from 2014. Over the same time period, we project mean orthopedic surgeon age to reach 62.4 years, if current growth rate persists.

Conclusion

During the study period, orthopedic surgeon, resident, and arthroplasty fellow volume have increased, although at a slower rate than TJA procedure growth. Renewed interest in arthroplasty fellowships has been demonstrated by an increase in the number and near complete filling of all available positions.

Keywords

total joint arthroplasty orthopedic surgeon orthopedic resident arthroplasty fellow epidemiology projection 

Notes

Compliance with Ethical Standards

Conflict of Interest

Matthew Sloan, MD, MS, and Ajay Premkumar, MD, MPH, declare that they have no conflicts of interest. Neil P. Sheth, MD, reports being a paid consultant to Zimmer, Smith & Nephew, and Medacta and receiving royalties from Elsevier, outside the submitted work.

Human/Animal Rights

N/A

Informed Consent

N/A

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

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Copyright information

© Hospital for Special Surgery 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Orthopaedic SurgeryHospital for Special SurgeryNew YorkUSA
  3. 3.Department of Orthopaedic SurgeryPennsylvania HospitalPhiladelphiaUSA

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