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Association between hospital procedure volume and risk of revision after total hip arthroplasty: a population-based study within the Nordic Arthroplasty Register Association database

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  • E N Glassou, University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Aarhus University, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Denmark. Electronic address: evagla@rm.dk.
  • ,
  • T B Hansen
  • K. Mäkelä, Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland; The Finnish Arthroplasty Register, Finland. Electronic address: Keijo.Makela@tyks.fi.
  • ,
  • Leif I Havelin, The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. Electronic address: leif.ivar.havelin@helse-bergen.no.
  • ,
  • Ove Furnes, The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. Electronic address: ove.nord.furnes@helse-bergen.no.
  • ,
  • M El-Badawy, Kysthospital in Hagavik, Haukeland University Hospital, Bergen, Norway. Electronic address: mona.badawy@helse-bergen.no.
  • ,
  • Johan Kärrholm, Institute of Clinical Sciences, Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: johan.karrholm@vgregion.se.
  • ,
  • Göran Garellick, Institute of Clinical Sciences, Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden; Swedish Hip Arthroplasty Register, Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: goran.garellick@registercentrum.se.
  • ,
  • Antti Eskelinen, Coxa Hospital for Joint Replacement, Tampere, Finland. Electronic address: antti.eskelinen@coxa.fi.
  • ,
  • Alma Becic Pedersen

OBJECTIVE: Outcome after total hip arthroplasty (THA) depends on several factors related to the patient, the surgeon and the implant. It has been suggested that the annual number of procedures per hospital affects the prognosis. We aimed to examine if hospital procedure volume was associated with the risk of revision after primary THA in the Nordic countries from 1995 to 2011.

DESIGN: The Nordic Arthroplasty Register Association database provided information about primary THA, revision and annual hospital volume. Hospitals were divided into five volume groups (1-50, 51-100, 101-200, 201-300, >300). The outcome of interest was risk of revision 1, 2, 5, 10 and 15 years after primary THA. Multivariable regression was used to assess the relative risk (RR) of revision.

RESULTS: 417,687 THAs were included. For the 263,176 cemented THAs no differences were seen 1 year after primary procedure. At 2, 5, 10 and 15 years the four largest hospital volume groups had a reduced risk of revision compared to group 1-50. After 10 years RR was for volume group 51-100 0.79 (CI 0.65-0.95), group 101-200 0.76 (CI 0.61-0.95), group 201-300 0.74 (CI 0.57-0.96) and group >300 0.57 (CI 0.46-0.71). For the uncemented THAs an association between hospital volume and risk of revision were only present for hospitals producing 201-300 THAs per year, beginning at years 2 through 5 and in all subsequent time intervals to 15 years.

CONCLUSION: Hospital procedure volume was associated with a long term risk of revision after primary cemented THA. Hospitals operating 50 procedures or less per year had an increased risk of revision after 2, 5, 10 and 15 years follow up.

Original languageEnglish
JournalOsteoarthritis and Cartilage
Volume24
Issue3
Pages (from-to)419-26
Number of pages8
ISSN1063-4584
DOIs
Publication statusPublished - Mar 2016

    Research areas

  • Adolescent, Adult, Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip, Cementation, Child, Databases, Factual, Female, Follow-Up Studies, Humans, Male, Middle Aged, Osteoarthritis, Hip, Prosthesis Failure, Registries, Reoperation, Risk Factors, Scandinavian and Nordic Countries, Workload, Young Adult, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't

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