Supporting Regional Upper Limb Arthroplasty: The Impact of Establishing an Upper Limb Orthopaedic Network

Abstract

Background and Objectives The management of complex upper limb arthroplasty has received national guidelines supporting the use of a regional network. An upper limb network was established for both elbow and shoulder arthroplasty. This study evaluates the impact of establishing this network over a 5-year period. Methods Data were collected from network meetings from June 2017 to December 2022. Hospital-level National Joint Registry data were obtained for analysis of case volume. Results A total of 243 cases were discussed. Network discussion changed the management plan in 53% of cases. Only 8% of cases required transfer to the tertiary center. The proportional caseload at either hub or spoke hospitals did not change after creation of the network. Discussion Regional network discussion aids decision-making for complex cases, with further management options realized in over half of the cases presented. The discussion allowed every patient to gain the advantage of regional expertise while being managed conveniently at their local hospital.