HIP International最新文献

{"title":"Application of interdisciplinary nursing care based on the concept of enhanced recovery after surgery in geriatric hip arthroplasty: a prospective study.","authors":"Jionghao Zhang, Yuting Zhou, Yan Zhang, Yaojin Zhang, Jian Liao, Zhiwei Qu, Yangchun Wu, Liuya Jiang, Xianggui Chen, Wenjuan Xu","doi":"10.1177/11207000251369719","DOIUrl":"https://doi.org/10.1177/11207000251369719","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the efficacy of interdisciplinary nursing care based on the concept of enhanced recovery after surgery (ERAS) during the perioperative period of geriatric hip arthroplasty.</p><p><strong>Methods: </strong>A prospective, single-centre, randomised, evaluator-blinded, case-control study was conducted involving 80 patients diagnosed with femoral neck fractures who underwent total hip arthroplasty from October 2021 to May 2023. Patients were randomly assigned to a control or experimental group (40 patients each). Clinical and surgery-related data were collected and compared between the 2 groups. Critical assessments included the Harris Hip Score (HHS), Barthel Index (BI), Berg Balance Scale (BBS), Numeric Rating Scale (NRS) for pain, Beck Anxiety Inventory (BAI), and Caprini thrombosis risk scale.</p><p><strong>Results: </strong>No significant differences between the 2 groups in baseline characteristics such as age, gender, BMI, surgery time, and complication rates (<i>p</i> > 0.05). The experimental group had shorter durations for catheter removal and postoperative ambulation (<i>p</i> < 0.05). Preoperative HHS and BI scores were similar in both groups, but at 1 week, 1 month, and 6 months postoperatively, the experimental group showed significantly higher HHS, BI, and BBS scores (<i>p</i> < 0.05). Anxiety levels (BAI) and thrombosis risk scores were comparable at all time points, except for significantly lower Caprini thrombosis and NRS pain scores in the experimental group at 1 month (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Interdisciplinary nursing care based on the ERAS concept improves joint function recovery and self-care abilities and shortens mobilisation time in geriatric hip arthroplasty patients, promoting enhanced overall recovery.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251369719"},"PeriodicalIF":1.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of preoperative virtual simulation planning on the treatment of acetabular fractures: a meta-analysis.","authors":"Jieyu Chen, Lei Bai, Sergei V Petrenko, Chaohui Wang, Bixiu Lei, Shuangping He, Meilan Zhai, Huawu Liu, Jianhui Yan","doi":"10.1177/11207000251369498","DOIUrl":"https://doi.org/10.1177/11207000251369498","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the impact of preoperative virtual simulation planning on intraoperative parameters, postoperative complications, and functional recovery in acetabular fracture surgery, thereby aiding in clinical decision-making regarding the most effective approach.</p><p><strong>Methods: </strong>We conducted a systematic search of articles in PubMed, Embase, Cochrane Library, and Web of Science databases up to July 14, 2023. All clinical studies comparing preoperative virtual simulation planning with conventional surgical treatment were included.</p><p><strong>Results: </strong>16 studies involving 593 patients were included. Among these studies, 6 were randomised controlled trials (RCTs), 1 was a prospective study, and 9 were retrospective studies. Compared to conventional surgery, preoperative virtual simulation planning-assisted surgery significantly reduced intraoperative time (weighted mean differences [WMD] -48.87; 95% CI, -61.15--36.59; <i>p</i> < 0.001), internal fixation time (WMD -29.83; 95% CI, -37.46--22.20; <i>p</i> < 0.001), intraoperative blood loss (WMD -259.95; 95% CI, -354.15--165.75; <i>p</i> < 0.001), and fluoroscopy frequency (WMD -4.56; 95% CI, -5.39--3.73; <i>p</i> < 0.001), as well as the incidence of postoperative complications (OR 0.34; 95% CI, 0.18-0.65; <i>p</i> = 0.001). There was no significant difference in fracture reduction quality between the preoperative virtual simulation planning group and the conventional group (OR 0.98; 95% CI, 0.75-1.29; <i>p</i> = 0.900), but the former had a higher rate of anatomical reduction (OR 3.00; 95% CI, 1.90-4.72; <i>p</i> < 0.001). There was no significant difference in hip joint function scores between the 2 groups (OR 1.01; 95% CI, 0.72-1.41; <i>p</i> = 0.974). However, the preoperative virtual simulation planning group had a higher proportion of patients with excellent scores (OR 2.32; 95% CI, 1.35-3.99; <i>p</i> = 0.002) and a lower proportion of patients with poor scores (OR 0.52; 95% CI, 0.14-1.92; <i>p</i> = 0.327).</p><p><strong>Conclusions: </strong>Compared to conventional surgery, preoperative virtual simulation planning is more effective in the treatment of acetabular fractures, resulting in shorter intraoperative and internal fixation times, reduced intraoperative blood loss, and lower fluoroscopy frequency. Moreover, in the follow-up period, the preoperative virtual simulation planning group exhibits a lower incidence of postoperative complications and superior fracture site recovery, resulting in better overall prognostic outcomes.Prospero registration:https://www.crd.york.ac.uk/PROSPERO/ (registration number: RD42023447807).</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251369498"},"PeriodicalIF":1.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic arm-assisted total hip arthroplasty enables accurate cup orientation and positioning in obese patients with osteoarthritis secondary to developmental dysplasia of the hip: a propensity score-matched comparative study.","authors":"Yasuyuki Omichi, Tomohiro Goto, Gakuto Yoshida, Yusaku Nakayama, Michihiro Takai, Ryosuke Sato, Tetsuya Enishi, Koichi Sairyo, Shunji Nakano","doi":"10.1177/11207000251378086","DOIUrl":"https://doi.org/10.1177/11207000251378086","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the accuracy of cup placement by the robotic arm-assisted system (Mako) in obese patients with developmental dysplasia of the hip (DDH).</p><p><strong>Methods: </strong>This retrospective single-centre study included 923 consecutive hips with primary robotic arm-assisted total hip arthroplasty (THA). After propensity score-matching, 80 hips with DDH each were selected for the obese group and non-obese group. Postoperative cup orientation and positioning were assessed by superimposition of a 3-dimensional cup template, using postoperative computed tomography images with pelvic coordinates matching the preoperative planning.</p><p><strong>Results: </strong>The absolute error of cup inclination and anteversion was comparable between the obese and non-obese groups (1.2 ± 1.0° vs. 1.2 ± 1.0° and 1.4 ± 1.0° vs. 1.6 ± 1.2°, respectively). The absolute error of the transverse, sagittal, and longitudinal axes between the obese and non-obese groups were 1.0 ± 0.9 mm vs. 1.4 ± 1.0 mm, 1.5 ± 1.0 mm vs. 1.3 ± 1.8 mm, and 1.4 ± 1.2 mm vs. 1.3 ± 0.9 mm (<i>p</i> = 0.02, <i>p</i> = 0.89, and <i>p</i> = 0.12, respectively). There was no significant difference in cup orientation or positioning in the obese group, regardless of body mass index.</p><p><strong>Conclusions: </strong>Robotic arm-assisted THA enables accurate cup placement even in obese patients with DDH.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251378086"},"PeriodicalIF":1.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[18F]-fluoride PET/CT analyses of postoperative bone mineralisation adjacent to femoral stems at THA: a randomised clinical trial.","authors":"Dimitrios Sotiriou, Jens Sörensen, Gösta Ullmark","doi":"10.1177/11207000251372025","DOIUrl":"https://doi.org/10.1177/11207000251372025","url":null,"abstract":"<p><strong>Purpose: </strong>The long-term success of total hip arthroplasty (THA) is dependent on support from the periprosthetic bone bed. We present a randomised study using 18F-fluoride Positron Emission Tomography/Computerised Tomography (F-PET/CT) to analyse bone metabolism in periprosthetic bone adjacent to femoral stems following THA surgery. To compare bone metabolism to cemented Exeter and uncemented SP-CL stems, patients with hip osteoarthritis were randomly assigned for THA with either cemented or uncemented femoral components. The results were analysed with F-PET/CT.</p><p><strong>Patients and methods: </strong>In 28 patients (28 cases) with hip osteoarthritis, a THA was performed. The patients received either an uncemented or a cemented femoral stem. The contralateral healthy femur was used as reference for normal bone metabolism. Patients' clinical scores, radiography and F-PET/CT were analysed at 4, 16 and 36 weeks postoperatively. PET results were analysed and presented in 13 regions of interest (ROI) adjacent to the whole stem-bone interface.</p><p><strong>Results: </strong>Clinical results were good in all patients, and no major complications were recorded. At radiography, all stems were stable. PET analyses after 4 weeks showed that bone mineralising activity was significantly higher around the SP-CL stems, both compared to the Exeter group and to the contralateral healthy reference femur group. The SP-CL also had prolonged raised activity compared to the Exeter group.</p><p><strong>Conclusions: </strong>A detailed analysis of bone formation patterns on the implant surface shows that early healing is associated with higher mineral deposition using the uncemented SP-CL stem.</p><p><strong>Clinical trial registration: </strong>The study was registered at ClinicalTrials.gov (identifier NCT02320682).</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251372025"},"PeriodicalIF":1.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive report on same-day discharge (SDD) following total hip arthroplasty (THA): a multicentre database analysis.","authors":"Halil Bulut, Maria Jose Maestre, Daniel Tomey","doi":"10.1177/11207000251357484","DOIUrl":"https://doi.org/10.1177/11207000251357484","url":null,"abstract":"<p><strong>Introduction: </strong>Same-day discharge (SDD) has gained increasing importance in orthopaedic surgery, particularly for hip and knee procedures. Despite initial concerns about the lack of extended hospital care, growing evidence demonstrates its benefits, including reduced in-hospital infections and significant financial and psychosocial advantages for patients and healthcare systems. This study examines the adoption and outcomes of SDD in total hip arthroplasty (THA).</p><p><strong>Method: </strong>A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2016 to 2021 was conducted to identify trends, predictors, and outcomes of SDD in THA.</p><p><strong>Results: </strong>In this study, a multicentre database analysis was performed on 235,393 patients, including 25,388 who were discharged on the same day following total hip arthroplasty. Patients undergoing same-day discharge THA were generally younger, with females comprising 48.3% of SDD cases compared to 55.6% in hospitalised patients. Operative times were shorter for SDD patients (83.9 minutes vs. 92.3 minutes). Postoperatively, SDD patients experienced significantly lower rates of 30-day readmissions (1.7% vs. 3.5%), procedure-related readmissions (1.0% vs. 2.1%), reoperations (1.1% vs. 1.9%), and mortality (0.02% vs. 0.04%). Predictors of unplanned readmissions in the SDD group included age >65 years (OR 2.0), hypertension (OR 1.6), chronic steroid use (OR 2.2), and severe COPD (OR 2.0), while gender, emergent surgery indication, and smoking were not significant predictors. The adoption of SDD increased markedly, rising from 1.5% in 2016 to 25.6% in 2021.</p><p><strong>Conclusions: </strong>Same-day discharge is a safe and effective option for appropriately selected THA patients, offering reduced readmission and reoperation rates, shorter operative times, and increased healthcare efficiency. This trend highlights a paradigm shift in perioperative care, improving patient outcomes and satisfaction.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251357484"},"PeriodicalIF":1.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern solutions in hip arthroplasty: a systematic review of short cemented stems.","authors":"Caria Clemente, Paciotti Michele, Papalia Giuseppe Francesco, Moncada Francesco, Basciani Susanna, Zampogna Biagio, Papalia Rocco","doi":"10.1177/11207000251366137","DOIUrl":"https://doi.org/10.1177/11207000251366137","url":null,"abstract":"<p><strong>Background: </strong>Most of the current evidence for short femoral stems in total hip arthroplasty (THA) is related to uncemented fixation. This study aims to summarise the existing evidence on the use of short cemented stems in THA, with a focus on overall implant survival, clinical outcomes, radiographic findings, and complication rates.</p><p><strong>Methods and materials: </strong>A systematic literature review was conducted following the PRISMA guidelines. 12 articles met the inclusion criteria. The risk of bias was assessed through the Methodological Index for Non-Randomized Studies (MINORS) score.</p><p><strong>Results: </strong>With a total of 5294 total hip replacement performed, the mean follow-up was 13.5 years. The most reported complications were dislocation, periprosthetic fracture, and infections; several studies reported varus and valgus stem malalignment. All the included studies demonstrated improved clinical outcomes.</p><p><strong>Conclusions: </strong>Short cemented stems are a reliable option for Dorr type A femurs, as well as for hypoplastic and small femurs. Their advantages include preservation of metaphyseal bone, easier insertion, and easier removal in case of revision. Varus and valgus stem-position should be studied as risk factors for failure. Despite small follow-up available, and considering different stem type and length, cemented short stems implants are a safe and effective option for THA.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251366137"},"PeriodicalIF":1.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long stem cemented revision arthroplasty offers shorter time to bone union and independent cane walking for periprosthetic femoral fracture.","authors":"Kenichi Oe, Shohei Sogawa, Tomohisa Nakamura, Yosuke Otsuki, Takashi Toyoda, Fumito Kobayashi, Hirokazu Iida, Takanori Saito","doi":"10.1177/11207000251371119","DOIUrl":"https://doi.org/10.1177/11207000251371119","url":null,"abstract":"<p><strong>Background: </strong>There have been few reports of long stem cemented revision arthroplasty in the treatment of periprosthetic fractures (PPFs). The purpose of this study was to retrospectively compare the clinical and radiological outcomes between osteosynthesis and long stem cemented revision arthroplasty for PPFs.</p><p><strong>Methods: </strong>This study retrospectively evaluated 29 femurs who underwent surgical treatment for PPF following total or bipolar hip arthroplasty. The mean duration of clinical follow-up was 5.0 (range 2-12) years. Surgical options included osteosynthesis only in 7 femurs (Group O) and long stem cemented revision arthroplasty in 22 femurs (Group R).</p><p><strong>Results: </strong>Repeat surgeries due to implant failure were performed in 2 (29%) and 1 (5%) in groups O and R, respectively. In the walking component of the mean Merle d'Aubigné clinical score at the last follow-up, there were significant differences between the groups. Mean time to independent cane walking was 24.0 (13.1-42.3) weeks and 7.2 (2.0-15.6) weeks in groups O and R, respectively (p < 0.05). Bone union rates were 71% and 95% in groups O and R, respectively (p = 0.14). Where bone union was successfully achieved, the mean time to bone union was 12.2 (6.1-22.2) months in group O and 6.6 (1.7-12.5) months in group R (p < 0.05).</p><p><strong>Conclusions: </strong>The time to independent cane walking and bone union was significantly shorter for long stem cemented revision arthroplasty. This procedure offers considerable advantages for patients, despite the difficulty of the procedure for surgeons.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251371119"},"PeriodicalIF":1.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quantitative analysis of the hip shuck test during robotic arm-assisted total hip arthroplasty.","authors":"David Fraser, Julie F Vermeir, Patrick B O'Connor, Nikola Poli, Anthony M Silva, William J Donnelly","doi":"10.1177/11207000251367640","DOIUrl":"https://doi.org/10.1177/11207000251367640","url":null,"abstract":"<p><strong>Background: </strong>The shuck test is a subjective method used intraoperatively to measure soft tissue tension during total hip arthroplasty (THA). This study aimed to introduce and quantify the shuck length vector magnitude in patients undergoing robotic arm-assisted THA, and identify factors affecting its value.</p><p><strong>Methods: </strong>This prospective cohort study analysed 95 primary THAs performed on 87 patients. Surgical data and intraoperative soft tissue tension measurements were recorded using the Mako robotic arm-assisted system. An exploratory analysis of factors affecting the shuck length vector magnitude was performed.</p><p><strong>Results: </strong>The mean shuck length vector magnitude was 8.7 mm. Shuck length vector magnitude was significantly higher in males as compared to females (<i>p</i> = 0.017). A strong inverse correlation was found between increased hip offset and hip length on shuck length vector magnitude (<i>p</i> < 0.001 and <i>p</i> = 0.004, respectively). Shuck length vector magnitude was not affected by femoral head size (<i>p</i> = 0.674) and arthritis severity (<i>p</i> = 0.141).</p><p><strong>Conclusions: </strong>This study demonstrates that it is possible to quantify soft tissue tension using the shuck test during robotic-assisted THA. Restoring hip offset is crucial for optimising joint stability. Future research should establish a threshold for acceptable shuck length vector magnitude and correlate this with dislocation rates and patient reported outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251367640"},"PeriodicalIF":1.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A safe technique in performing gluteus maximus tenotomy in the Kocher-Langenbeck approach.","authors":"Jiun-Lih Lin, Andrew Holmes, Joseph Lynch, Thomas Ward, Paul N Smith, Catherine L Hayter","doi":"10.1177/11207000251369368","DOIUrl":"https://doi.org/10.1177/11207000251369368","url":null,"abstract":"<p><strong>Background: </strong>Gluteus maximus (GMax) tenotomy is a well described technique to improve femoral and/or acetabular exposure during the Kocher Langenbeck approach. Branches of the first femoral perforator artery (1FPA) are frequently encountered and may be injured during the tenotomy, causing bleeding and obscuration of surgical field. The understanding of vascular anatomy around GMax insertion is poor. This study aims to identify the origin, size, course, and consistency of these vessels, and a safe technique for GMax tenotomy.</p><p><strong>Methods: </strong>100 eligible computed-tomography angiograms (CTA) of the lower-limbs were identified between January 2019 and July 2021 with 200 limbs studied. The gluteal tuberosity (GTu) was set as the origin of GMax tendon insertion. CTAs were reconstructed in multiplanar reformats, including 3D reconstructions. The 1FPA and its branches were mapped, their anatomical course, size, and relationship with GTu and posterior femoral cortex were recorded.</p><p><strong>Results: </strong>Average age of cohort was 66.5years. Out of 200 limbs, 2 anatomical arterial variants of the 1FPA were identified near the gluteal tubercle. 23 limbs (11.5%) had a proximal (high) take-off of the 1FPA. 177 (88.5%) had a long ascending vessel originating from the 1FPA. The courses of both arteries are consistent. The average luminal size of these vessels was 2.1 mm. In terms of vertical distance, 12 (6%) limbs had an artery within 15 mm from the GTu, the assumed top of GMax tendon insertion. All 200 vessels were seen within 10 mm of the posterior cortex. The combination of these findings make up the \"safe-zone\" of GMax tenotomy.</p><p><strong>Conclusions: </strong>This is the first to detail the origin, course, and size of the ascending artery in relation to GMax tendon. The \"Safe zone\" of GMax tenotomy is a 15-mm partial release, at least 10 mm off the posterior femoral cortex.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251369368"},"PeriodicalIF":1.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-volume revision surgeons are more cost-effective following revision total hip and knee arthroplasty.","authors":"Akram A Habibi, Utkarsh Anil, Mackenzie A Roof, Charles C Lin, Ran Schwarzkopf","doi":"10.1177/11207000251358178","DOIUrl":"10.1177/11207000251358178","url":null,"abstract":"<p><strong>Background: </strong>With the increased rates of revision total hip (rTHA) and total knee arthroplasty (rTKA), the financial burden of these procedures is at risk of straining the healthcare system. Our study sought to create a model to evaluate the cost-effectiveness of rTKA and rTHA performed by high-volume (HV) and low-volume (LV) surgeons.</p><p><strong>Methods: </strong>The database of rTKA and rTHA from April 2018 to March 2021 at our academic institution was retrospectively reviewed. Surgeons above the 90^th percentile in annual volume were classified as HV surgeons and the remainder were classified as LV surgeons. Previously published cost estimates were utilised for operative time, hospital length of stay (LOS), discharge disposition, 90-day readmission, and 1-year re-revision.</p><p><strong>Results: </strong>A total of 442 rTKA were performed by 30 surgeons and 420 rTHA were performed by 32 surgeons. 3 surgeons were HV in each group with HV surgeons performing 213 (48.2%) rTKA and 215 (51.2%) rTHA in the study period. LV surgeons had longer operative times for both rTKA (167.1 vs. 145.8 minutes; <i>p</i> < 0.001) and rTHA (172.5 vs. 151.2 minutes; <i>p</i> < 0.001). Both groups had equivalent discharge disposition, 90-day readmission, and 1-year re-revision. HV surgeons had lower estimated mean costs for rTHA ($22,027.81 vs. $24,617.39) and rTKA ($20,343.23 vs. $18,554.67).</p><p><strong>Conclusions: </strong>HV surgeons have a lower estimated mean cost for both rTHA and rTKA. Healthcare systems may benefit from having rTHA and rTKA procedures performed by HV surgeons who are able to perform these revision procedures for a lower cost without negatively impacting patient outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"510-516"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}