Revision total joint arthroplasty (rTJA) has escalated into one of the most resource-intensive segments of modern orthopedics, with projections indicating a substantial downstream burden on global healthcare infrastructure. Achieving structural durability in secondary joint revisions demands an extraordinary tier of surgical mastery, meticulous anatomical exposure, and adaptive intraoperative decision-making. Despite this extreme complexity, a hidden paradox frequently persists within academic and hospital scheduling blocks: the least experienced, early-career surgeons are disproportionately delegated or assigned these highly complex reconstructive procedures via unstratified open-access emergency or clinic rotations.
While the impact of absolute annual surgeon volume has been thoroughly evaluated in historical health policy literature, the specific role of surgeon experience—operationally defined as absolute years in independent clinical practice—remains poorly understood in the context of secondary revision surgery. Many hospital value committees operate under the flawed assumption that passing an elite adult reconstruction fellowship automatically yields standard procedural efficiency. We set out to investigate if an independent multi-year surgical learning curve exists for fellowship-trained surgeons by directly auditing their early to mid-career complication and timing baselines.
