Two Short-Term Outcomes After Instituting a National Regulation Regarding Minimum Procedural Volumes for Total Knee Replacement

Abstract

Implementation of the minimum-volume regulation for total knee replacement resulted in more patients being managed at higher-volume hospitals than expected. Following the implementation of a minimum-volume regulation, effects on two short-term outcome parameters were observed, but definite conclusions could only be made regarding wound infection, with the minimum-volume regulation resulting in a decreased rate of infection.

Safety of Ventricular Tachycardia Ablation in Clinical Practice

“…For instance in Germany, minimum volume requirements for total knee replacement resulted in 22.5% and 44% risk reductions in wound infections and bleeding complications, respectively. 29 Within electrophysiology, lower complication rates have recently been reported in higher volume device implantation centers and among higher volume operators for device implantation and atrial fibrillation ablation. 23,30,31 Whether concentrating ablation volume to select centers is a practical approach to decreasing complication rates in VT ablation is not clear.…”

Impact of department volume on surgical site infections following arthroscopy, knee replacement or hip replacement

“…Moreover, we did not find any indicators that there are small ‘centres of excellence,’ that is, low volume centres with very low SSI rates. A recently published study of German hospitals before and after the implementation of the minimum volume regulation demonstrated a risk reduction of 22.5% for postoperative wound infections 25. Volume–outcome relationships can be explained by more effective routine performance and by the implementation of policies and pathways in medium- or high-volume departments, although surgical practice can vary considerably 26.…”

Influence of Hospital Volume on Revision Rate After Total Knee Arthroplasty with Cement

“…A higher short-term risk of complications such as wound infection after total knee arthroplasty has been associated with lower hospital and surgeon volume 21 . There also have been reports of higher risks of perioperative and postoperative complications and adverse outcomes (including pneumonia, acute myocardial infarction, pulmonary embolus, and deep infection) and higher rates of mortality in low-volume hospitals [9][10][11] .…”