PMID- 37476850
OWN - NLM
STAT- MEDLINE
DCOM- 20230922
LR  - 20230922
IS  - 1940-5480 (Electronic)
IS  - 1067-151X (Linking)
VI  - 31
IP  - 19
DP  - 2023 Oct 1
TI  - The Effect of Surgeon and Hospital Volume on Total Knee Arthroplasty 
      Patient-reported Outcome Measures: An American Joint Replacement Registry Study.
PG  - 1026-1031
LID - 10.5435/JAAOS-D-22-01171 [doi]
AB  - BACKGROUND: The lower morbidity and mortality rate associated with increased 
      surgeon and hospital volume may also correlate with improved patient-reported 
      outcome measures. The goal of this study was to determine the relationship 
      between surgeon and hospital volume and patient-reported outcome measures after 
      total knee arthroplasty (TKA) using American Joint Replacement Registry data. 
      METHODS: Using American Joint Replacement Registry data from 2012 to 2020, 8,193 
      primary, elective TKAs with both preoperative and 1-year postoperative The Knee 
      Injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS-JR) scores were 
      analyzed. This study was powered to detect the minimally clinical important 
      difference (MCID). The main exposure variables were median annual surgeon and 
      hospital volume. Tertiles were formed based on the median annual number of TKAs 
      performed: low-volume surgeons (1 to 52), medium-volume (53 to 114), and 
      high-volume (>/=115); low-volume hospitals (1 to 283), medium-volume (284 to 602), 
      and high-volume (>/=603). The mean preoperative and 1-year postoperative KOOS-JR 
      were compared. Multivariable logistic regression models were used to determine 
      the effect of surgeon and hospital volume and demographics on achieving the MCID 
      for KOOS-JR. RESULTS: The mean preoperative and 1-year postoperative KOOS-JR 
      score for low-volume surgeons was 47.78 +/- 13.50 and 77.75 +/- 16.65, respectively, 
      and 47.32 +/- 13.73 and 76.86 +/- 16.38 for low-volume hospitals. The mean 
      preoperative and 1-year postoperative KOOS-JR score for medium-volume surgeons 
      was 47.20 +/- 13.46 and 76.70 +/- 16.98, and 48.93 +/- 12.50 and 77.15 +/- 16.36 for 
      medium-volume hospitals. The mean preoperative and 1-year postoperative KOOS-JR 
      scores for high-volume surgeons were 49.08 +/- 13.04 and 78.23 +/- 16.72, and 48.11 +/- 
      13.47 and 78.23 +/- 17.22 for high-volume hospitals. No notable difference was 
      observed in reaching MCID for KOOS-JR after adjustment for potential confounders. 
      CONCLUSION: An increased number of TKA cases performed by a given surgeon or at a 
      given hospital did not have an effect on achieving MCID for KOOS-JR outcomes.
CI  - Copyright (c) 2023 by the American Academy of Orthopaedic Surgeons.
FAU - Muthusamy, Nishanth
AU  - Muthusamy N
AUID- ORCID: 0000-0003-1227-7093
AD  - From the Department of Orthopedic Surgery, Huntington Hospital, Zucker School of 
      Medicine Hofstra/Northwell, Huntington, NY (Lygrisse), and the Department of 
      Orthopedic Surgery, NYU Langone Health, New York, NY (Muthusamy, Sicat, 
      Schwarzkopf, Slover, and Rozell).
FAU - Lygrisse, Katherine A
AU  - Lygrisse KA
FAU - Sicat, Chelsea S
AU  - Sicat CS
FAU - Schwarzkopf, Ran
AU  - Schwarzkopf R
FAU - Slover, James
AU  - Slover J
FAU - Rozell, Joshua C
AU  - Rozell JC
LA  - eng
PT  - Journal Article
DEP - 20230719
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, Knee
MH  - Retrospective Studies
MH  - *Surgeons
MH  - Registries
MH  - Patient Reported Outcome Measures
MH  - Hospitals, High-Volume
MH  - *Osteoarthritis, Knee/surgery
MH  - Treatment Outcome
MH  - Knee Joint/surgery
EDAT- 2023/07/21 06:43
MHDA- 2023/09/22 06:42
CRDT- 2023/07/21 04:12
PHST- 2022/12/21 00:00 [received]
PHST- 2023/06/06 00:00 [accepted]
PHST- 2023/09/22 06:42 [medline]
PHST- 2023/07/21 06:43 [pubmed]
PHST- 2023/07/21 04:12 [entrez]
AID - 00124635-990000000-00758 [pii]
AID - 10.5435/JAAOS-D-22-01171 [doi]
PST - ppublish
SO  - J Am Acad Orthop Surg. 2023 Oct 1;31(19):1026-1031. doi: 
      10.5435/JAAOS-D-22-01171. Epub 2023 Jul 19.