Is the future full of joint revision surgeries . . .

. . . for fellowship trained joints surgeons in academia?

With the projected huge increase in demand for joints, there will also be an increased demand for revisions.

If my logic is correct, most fellowship trained joint surgeons will have busy days doing harder cases, including revisions. If this is the case, I would suppose that the need for primaries will be filled in the community.

Do you think that there any truth to this scenario? If there is, and I want to do primary joints and mostly general ortho, maybe no fellowship at all would be the way to go.

Please, tell me the future . . .

Obama will further decrease what you make per joint replacement and chiropractors will start competing with podiatrists on who has more right to replace a hip. Welcome to the future.

Do the primaries and send your revisions away? Nice.

Of course you would do your own revisions. I'm talking about referrals.

The # of hip and knee primary replacements required will be far greater than the # of orthopaedic surgeons available to them in the coming decades, regardless of the $$ being paid, it's simply a matter of supply and demand. Dr. Fehring published a paper reporting on the #'s, go the AAOS website and u can find.

Absolutely the $$ will cause orthopods to not to want to to a primary hip and knee if the reimbursement for medicare continues to drop, surgeons may drop out of medicare all togthether and it may be cash only or ??

So yes as a generalist you will have work to do primary joints. Likely you won't be able to do your own revisions and have to send them out. It's more of a matter of skill than anything...that's what fellowships are for. If u are a generalist you may do primary ACL's etc but if a revision comes in you may send it to a sports fellowship guy or a posterolateral corner multiligament knee etc.

fyi...i am applying for joints fellowships

Thank you for the thoughtful response.