PMID- 36450013
OWN - NLM
STAT- MEDLINE
DCOM- 20230213
LR  - 20230504
IS  - 1940-5480 (Electronic)
IS  - 1067-151X (Linking)
VI  - 31
IP  - 4
DP  - 2023 Feb 15
TI  - The Effect of Surgeon and Hospital Volume on Total Hip Arthroplasty 
      Patient-Reported Outcome Measures: An American Joint Replacement Registry Study.
PG  - 205-211
LID - 10.5435/JAAOS-D-22-00525 [doi]
AB  - BACKGROUND: Some studies have shown lower morbidity and mortality rates with 
      increased surgeon and hospital volumes after total hip arthroplasty (THA). This 
      study sought to determine the relationship between surgeon and hospital volumes 
      and patient-reported outcome measures after THA using American Joint Replacement 
      Registry data. METHODS: Using American Joint Replacement Registry data from 2012 
      to 2020, 4,447 primary, elective THAs with both preoperative and 1-year 
      postoperative Hip Dysfunction and Osteoarthritis Outcome Score for Joint 
      Replacement (HOOS-JR) scores were analyzed. This study was powered to detect the 
      minimum clinically important difference (MCID). The main exposure variables were 
      median annual surgeon and hospital volumes. Tertiles were formed based on the 
      median annual number of THAs conducted: low-volume (1 to 42), medium-volume (42 
      to 96), and high-volume (>/=96) surgeons and low-volume (1 to 201), medium-volume 
      (201 to 392), and high-volume (>/=392) hospitals. Mean preoperative and 1-year 
      postoperative HOOS-JR scores were compared. RESULTS: Preoperative HOOS-JR scores 
      were significantly higher at high-volume hospitals than low-volume and 
      medium-volume hospitals (49.66 +/- 15.19 vs. 47.68 +/- 15.09 and 48.34 +/- 15.22, P < 
      0.001), although these differences were less than the MCID. At the 1-year 
      follow-up, no difference was noted with no resultant MCID. Preoperative and 
      1-year HOOS-JR scores did not markedly vary with surgeon volume. In multivariate 
      regression, low-volume and medium-volume surgeons and hospitals had similar odds 
      of MCID achievement in HOOS-JR scores compared with high-volume surgeons and 
      hospitals, respectively. CONCLUSION: Using the HOOS-JR score as a validated 
      patient-reported outcome measure, higher surgeon or hospital THA volume did not 
      correlate with higher postoperative HOOS-JR scores or greater chances of MCID 
      achievement in HOOS-JR scores compared with medium and lower volume surgeons and 
      hospitals.
CI  - Copyright (c) 2022 by the American Academy of Orthopaedic Surgeons.
FAU - Oakley, Christian T
AU  - Oakley CT
AUID- ORCID: 0000-0001-7668-3715
AD  - From the Department of Orthopedic Surgery, NYU Langone Health, New York, NY 
      (Oakley, Arraut, Schwarzkopf, and Slover) and the Department of Orthopedic 
      Surgery, Zucker School of Medicine Hofstra/Northwell, Huntington, NY (Lygrisse).
FAU - Arraut, Jerry
AU  - Arraut J
FAU - Lygrisse, Katherine
AU  - Lygrisse K
FAU - Schwarzkopf, Ran
AU  - Schwarzkopf R
FAU - Slover, James D
AU  - Slover JD
FAU - Rozell, Joshua C
AU  - Rozell JC
LA  - eng
PT  - Journal Article
DEP - 20221129
PL  - United States
TA  - J Am Acad Orthop Surg
JT  - The Journal of the American Academy of Orthopaedic Surgeons
JID - 9417468
SB  - IM
MH  - Humans
MH  - United States
MH  - *Arthroplasty, Replacement, Hip
MH  - Registries
MH  - Patient Reported Outcome Measures
MH  - Hospitals
MH  - *Surgeons
MH  - Treatment Outcome
EDAT- 2022/12/01 06:00
MHDA- 2023/02/14 06:00
CRDT- 2022/11/30 15:13
PHST- 2022/05/26 00:00 [received]
PHST- 2022/10/08 00:00 [accepted]
PHST- 2022/12/01 06:00 [pubmed]
PHST- 2023/02/14 06:00 [medline]
PHST- 2022/11/30 15:13 [entrez]
AID - 00124635-202302150-00006 [pii]
AID - 10.5435/JAAOS-D-22-00525 [doi]
PST - ppublish
SO  - J Am Acad Orthop Surg. 2023 Feb 15;31(4):205-211. doi: 10.5435/JAAOS-D-22-00525. 
      Epub 2022 Nov 29.