6 key trends in total joint arthroplasty: High vs. low volume hospitals

Written by Laura Dyrda | May 11, 2016 | Print  |

A new article published in the Journal of Bone and Joint Surgery examines a trend toward high-volume hospitals for hip and knee surgery.

The researchers examined the Nationwide Inpatient Sample for total knee and total hip arthroplasty patients from 2000 to 2012 and identified elective primary procedures by hospital. They also considered county geographic and population data as well as surgical complication rates for hospitals from 2009 to 2012.


The researchers found:


1. There was a "marked" increase in hospitals performing 400 or more elective primary total hip and knee arthroplasties. By 2012, 65.5 percent of arthroplasties were performed at high volume hospitals doing 400 or more cases per year.


2. Over the 12 year period examined, total knee and hip arthroplasties jumped from 33 in 2000 to 851,000 in 2012.


3. In 2012, 26.6 percent of arthroplasties were performed at very high-volume hospitals where 1,000 procedures or more are performed annually.


4. Hospitals where surgeons perform less than 100 arthroplasties dropped from 17.9 percent in 2000 to 5.4 percent in 2012.


5. The very high-volume hospitals had the lowest complication rates at 2.745 per 100 patients while low-volume hospitals reported the highest complication rates at 3.61 per 100 patients.


6. Most Americans — 81.9 percent — live within 50 miles of a high-volume arthroplasty hospital.


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