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High Volume of Hip Replacements Linked with Better Outcome

Posted on: 11/16/2004
One thousand in one year. That's how many total hip replacements (THRs) were done at one hospital in Philadelphia, Pennsylvania. This study reports the results of those 1000 THRs. The hope is to find ways to prevent complications after the operation. The researchers also wanted to know if the complication rate goes down as the number of THRs a hospital does goes up.

All patients were getting either their first total hip replacement or a revision of an implant already in place. All operations were done by one of three senior surgeons. The authors report a complication rate of 7.9 percent for first-time THRs. There was a much higher (16.5 percent) rate in hips that were revised.

There were a total of five deaths in both groups. The exact cause of death was unknown in each case. From the patients' records, it didn't look like any deaths were directly linked to the THR. Other data was collected and reported. This included length of hospital stay, complications, and number of patients readmitted to the hospital.

The authors conclude that the number of problems after THR (including death) goes down when the number of operations (volume) goes up. There is a point at which complications plateau. In other words, the rate doesn't keep going down to zero no matter how high the volume.

Peter F. Sharkey, MD, et al. Relationship Between Surgical Volume and Early Outcomes of Total Hip Arthroplasty. In The Journal of Arthroplasty. September 2004. Vol. 19. No. 6. Pp. 694-699.

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