Sloan Matthew, Premkumar Ajay, Sheth Neil P
Department of Orthopaedic Surgery, University of Pennsylvania, 3737 Market Street, 6th Floor, Philadelphia, PA 19104 USA.
Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
HSS J. 2020 Dec;16(Suppl 2):210-215. doi: 10.1007/s11420-019-09678-y. Epub 2019 Apr 9.
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.
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.
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.
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.
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.
在美国，全关节置换术（TJA）的手术量持续增长，但先前的报告表明，由于退休以及对关节置换术 fellowship 兴趣的减弱，骨科医生的供应可能无法满足未来的需求。
我们试图评估骨科医生、骨科住院医师和关节置换术 fellowship 的数量增长趋势，以预测未来每位外科医生 TJA 手术量的变化。
我们回顾性分析了 1995 年至 2017 年来自美国骨科医师学会、国家住院医师匹配计划、美国骨科协会住院医师匹配、旧金山匹配和国家住院患者样本的数据。确定了 TJA 手术率以及骨科医生、住院医师和 fellowship 学员数量的年增长情况。
TJA 手术量增加了 129%，骨科医生数量增加了 15.6%，骨科住院医师数量增加了 29.4%。关节置换术 fellowship 职位的填补率从 81.9%提高到了 96.4%，关节置换术 fellowship 职位数量增加了 33.5%。外科医生的平均年龄从 50.9 岁增加到了 56.5 岁。到 2030 年，我们估计每位外科医生每年将进行 90.1 例 TJA 手术，比 2014 年增加 57%。在同一时期，如果当前的增长率持续下去，我们预计骨科医生的平均年龄将达到 62.4 岁。
在研究期间，骨科医生、住院医师和关节置换术 fellowship 学员数量有所增加，尽管增速低于 TJA 手术的增长速度。对关节置换术 fellowship 的兴趣重新燃起，表现为职位数量的增加以及所有可用职位几乎全部被填补。
