The effect of surgeon volume on the need for transfusion following primary unilateral hip and knee arthroplasty

Accuracy of Acetabular Component Position in Hip Arthroplasty

“…This supports the twofold risk determined by the previous group. Multiple studies have examined surgeon volume in relation to transfusion rates, readmission rates, length of hospital stay, dislocation, preoperative diagnosis, and other outcome measures 5,6,34,35 . In our analysis, we differentiated surgeon volume and experience as separate categories and, to our knowledge, this has not been reported previously.…”

Does surgical volume affect outcome after primary and revision knee arthroplasty? A systematic review of the literature

“…Following review nine of these papers were discarded for the following reasons: three were duplicates [3,8,13], two were editorials, one looked at the effect of physician owned hospitals on general competing hospitals, one looked at rural hospitals, one was a letter to the editor and one paper focused on Medicaid status. This left 21 papers of which nine were related to the knee [16][17][18][19][20][21][22][23][24], often as a more general assessment of the effect of volume on lower limb arthroplasty, and 12 looking at other aspects of orthopaedic practice [25][26][27][28][29][30][31][32][33][34][35][36]. An additional two papers [37,38] were also identified through a review of the bibliographies of identified papers.…”

“…Baker et al [21] found a surgeon volume of b52 TKR or THR/year led to a significant rise in the rate of transfusion rates following both hip and knee replacement. Whilst complications were seen uncommonly, Judge et al [6] found that they were still seen more frequently in low volume trusts doing b50 arthroplasties annually and in non-training centres following TJRs.…”

“…Based on the literature presented one would assume that high volume surgeons, who are associated with decreased mortality, length of stay and complication rates as well as improved patient outcomes, should consistently achieve excellent results despite hospital volume [6,8,13,[16][17][18][20][21][22][26][27][28][29][30][31][35][36][37][38]. Harmon et al [61], in their work looking at outcomes after colorectal resection, however, found that when medium volume surgeons operated in medium or high volume centres they could still achieve results as good as high volume surgeons.…”

Customization of cutting blocks: Can this address the problem?

“…Surgeons and hospitals will need to improve their proficiency and volume to better accommodate the increased number of joint replacements. Improving proficiency will allow for increased surgeon volume, which has been shown to improve both immediate postoperative course as well as long-term survival of implants [3][4][5][6].…”