» Articles » PMID: 29123655

Does Surgeon Volume Affect the Outcome of Total Knee Arthroplasties in a Developing Country? - A Retrospective Cohort Study

Overview
Publisher Wolters Kluwer
Specialty Medical Education
Date 2017 Nov 11
PMID 29123655
Citations 2
Authors
Affiliations
Soon will be listed here.
Abstract

Introduction: Recent studies have shown that in addition to patient factors, surgeon volume has influenced total knee arthroplasty (TKA) outcomes greatly. With recent propositions of regionalization of arthroplasties to higher volume centers, the need for further evidence is warranted.

Materials And Methods: Retrospective Cohort Study done at Aga Khan University Hospital, Pakistan from January 2007 to December 2015. High Volume (HV) group was set as at least 50 TKAs/year and Low Volume (LV) was set as at most 25 TKAs/year. A total of 615 patients undergoing a unilateral or bilateral TKA were included in our study.

Results: LV group was associated with a higher length of stay (LOS) as compared to HV group in patients undergoing a bilateral TKA after adjusted logistic regression [OR 2.395 (1.47,3.91)]. We found no association between surgeon volume and postoperative complications.

Conclusion: Patients getting a bilateral TKA by LV surgeons were twice more likely to have a longer LOS as compared to HV group. Further research is warranted comparing all aspects and possible confounders to different variables before a conclusion can be made.

Citing Articles

Total Knee Arthroplasty, All-in-One versus Four-in-One Femoral Cutting Jig System: A Comparison Study.

Pratama A, Irianto K, Setiawati R, De Vega B Adv Orthop. 2022; 2022:2055537.

PMID: 35860458 PMC: 9293532. DOI: 10.1155/2022/2055537.


Predicted effect of regionalised delivery care on neonatal mortality, utilisation, financial risk, and patient utility in Malawi: an agent-based modelling analysis.

Shrime M, Iverson K, Yorlets R, Roder-DeWan S, Gage A, Leslie H Lancet Glob Health. 2019; 7(7):e932-e939.

PMID: 31200892 PMC: 6581692. DOI: 10.1016/S2214-109X(19)30170-6.

References
1.
Bozic K, Maselli J, Pekow P, Lindenauer P, Vail T, Auerbach A . The influence of procedure volumes and standardization of care on quality and efficiency in total joint replacement surgery. J Bone Joint Surg Am. 2010; 92(16):2643-52. DOI: 10.2106/JBJS.I.01477. View

2.
Ong K, Lau E, Manley M, Kurtz S . Patient, hospital, and procedure characteristics influencing total hip and knee arthroplasty procedure duration. J Arthroplasty. 2008; 24(6):925-31. DOI: 10.1016/j.arth.2008.07.002. View

3.
Lau R, Perruccio A, Gandhi R, Mahomed N . The role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature. BMC Musculoskelet Disord. 2012; 13:250. PMC: 3534547. DOI: 10.1186/1471-2474-13-250. View

4.
Ritter M, Albohm M, Keating E, Faris P, Meding J . Comparative outcomes of total joint arthroplasty. J Arthroplasty. 1995; 10(6):737-41. DOI: 10.1016/s0883-5403(05)80068-3. View

5.
Katz J, Barrett J, Mahomed N, Baron J, Wright R, Losina E . Association between hospital and surgeon procedure volume and the outcomes of total knee replacement. J Bone Joint Surg Am. 2004; 86(9):1909-16. DOI: 10.2106/00004623-200409000-00008. View