The Practice Experience of an Adult Reconstruction Surgeon: A Cross-Sectional Analysis and Survey of the American Association of Hip and Knee Surgeons Membership

Abstract

Background: As demand for total hip arthroplasty and total knee arthroplasty increases, more surgeons have pursued subspecialty training in adult reconstruction. However, little information is available regarding the practice environment in which these fellowship-trained surgeons practice. The purpose of this study was to describe the practice environments of contemporary adult reconstruction surgeons. Methods: A survey was developed and distributed to members of the American Association of Hip and Knee Surgeons from December 2022 to January 2023. Information was collected on surgeon demographics, practice setting, call requirements, and educational debt. Responses were recorded using frequencies and proportions. Results: A total of 886 of 2471 (36%) surgeons completed the survey, with 93% identifying as male and 81% as white. The primary surgical practice locations were: community hospital 53%, academic/tertiary hospital 24%, specialty orthopedic hospital 17%, and ambulatory surgery center 7%. Nearly half (49%) of the respondents practiced in orthopedic specialty groups, and 60% spent 50%-66% of their clinical time in the office. The majority of surgeons performed between 101-250 (20%) and 251-400 (31%) arthroplasty cases per year, though this varied considerably. Call was taken by 77% of surgeons, yet only 54% received compensation. Conclusions: The most common practice setting for adult reconstruction surgeons was in a community-based hospital as part of a large orthopedic specialty group. Despite the considerable variability in annual procedure volume, the majority of surgeons spent over half their clinical time in office and had call obligations with variable compensation models.