Lower volume, higher risk: 4 things to know about a total hip arthroplasty study

To achieve the best results, volume-based strategies for improving total hip arthroplasty outcomes should use evidence-based benchmarks, according to study results in The Journal of Bone and Joint Surgery.

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Here are four things to know:

1. Study authors used New York statewide patient data from 1997 to 2014. The information was used to derive risk-based hospital and surgeon-volume categories for primary THA based on relationships with 90-day complications and mortality and two-year revision.

2. More than 35 percent of THA cases were conducted by surgeons performing between zero to 12 THAs annually. These cases were associated with a 2- to 2.5-fold increase in complication, mortality and revision risks relative to higher-volume surgeons.

3. About 15 percent of THA cases occurred in hospitals that conducted less than 54 THAs annually. These cases were associated with a nearly 1.5-fold increase in complications and between a 4- and 6-fold increase in mortality.

4. Traditional nonevidence-based quartile categories failed to capture the full magnitude of the volume-related differences.

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