High volume total hip arthroplasty surgeons have improved perioperative outcomes and short-term cumulative revision rates.

IF 1.3 4区医学 Q3 ORTHOPEDICS

HIP International Pub Date : 2025-06-27 DOI:10.1177/11207000251350102

Theodor Di Pauli von Treuheim, Utkarsh Anil, Charles C Lin, Matthew T Kingery, Joshua Rozell, Ran Schwarzkopf

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引用次数: 0

Abstract

Background: The relationship between total hip arthroplasty (THA) surgeon volume and outcomes is informative in this era of health care value optimisation. The purpose of this study was to evaluate outcomes based on modern-day surgeon practice volumes.

Methods: The SPARCS database was queried for patients undergoing primary THA from 2010 to 2020. Annual case volume thresholds were 30 and 150, differentiating high-volume (HV), intermediate-volume (IV), and low-volume (LV) groups. Perioperative outcomes and all-cause cumulative revision rates were evaluated.

Results: There were 88,411, 142,201, and 53,276 in the HV, IV, and LV groups, respectively. HV surgeons had significantly lower 3-month prosthetic joint infection (PJI) rates (0.5 vs. 0.8 vs. 1.0%, p < 0.001). While controlling for confounders, multivariate regression revealed increased odds of PJI for IV (1.5) and LV (1.87) and increased all-cause revision hazard ratio for IV (1.1) and LV (1.3). Cumulative revision rates were lower for HV at 1 and 2 years, but rates converged with IV group at 9 years.

Conclusions: HV surgeons have the most favourable short-term outcomes. However, in the long-term the difference in all-cause revision event rates becomes less apparent.

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大容量全髋关节置换术改善了围手术期疗效和短期累积翻修率。

背景：在这个医疗保健价值优化的时代，全髋关节置换术（THA）手术量与结果之间的关系具有信息性。本研究的目的是评估基于现代外科医生实践量的结果。方法：对2010 - 2020年接受原发性THA手术的患者进行SPARCS数据库查询。年病例量阈值为30和150，区分高容量（HV）、中容量（IV）和低容量（LV）组。评估围手术期预后和全因累积翻修率。结果：HV组88,411例，IV组142,201例，LV组53276例。HV外科医生的3个月假体关节感染（PJI）率显著降低（0.5比0.8比1.0%,p 0.001）。在控制混杂因素的情况下，多因素回归显示IV（1.5）和LV（1.87）的PJI几率增加，IV（1.1）和LV（1.3）的全因修正风险比增加。HV组在1年和2年的累计修正率较低，但在9年时与IV组趋同。结论：HV手术具有较好的短期预后。然而，从长期来看，全因复习事件发生率的差异变得不那么明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIP International 医学-整形外科

CiteScore

4.20

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology