Are TKAs Performed in High-volume Hospitals Less Likely to Undergo Revision Than TKAs Performed in Low-volume Hospitals?

• DOI: 10.1007/s11999-017-5463-x
• Publication Date: 2017-08-11T14:12:29Z
• Authors: Elke Jeschke; Mustafa Citak; Christian Günster; Andreas Matthias ...; Karl-Dieter Heller; Jürgen Malzahn; Fritz Uwe Niethard; Peter Schräder; Josef Zacher; Thorsten Gehrke
• Keywords: Sports medicine

Background High-volume hospitals have achieved better outcomes for THAs and unicompartmental knee arthroplasties (UKAs). However, few studies analyzed implant survival after primary TKA in high-volume centers. Questions/Purposes Is the risk of revision surgery higher when receiving a low-volume hospital than hospital? Methods Using nationwide billing data largest German healthcare insurer inpatient treatment, we identified 45,165 TKAs 44,465 patients insured by Allgemeine Ortskrankenkasse who had undergone replacement between January 2012 December 2012. Revision rates were calculated at 1 2 years all knees. The volume was using quintiles number performed each center. We used multiple logistic regression to model odds as function volume. Age, sex, 31 comorbidities, variables socioeconomic status included independent model. Results After controlling factors, patient age, found that having associated with decreased within index procedure. ratio 2-year 1.6 (95% CI, 1.4-2.0; p < 0.001) an annual 56 or fewer cases, 1.5 1.3-1.7; 57 93 1.2 1.0-1.3; = 0.039) 94 144 1.1 0.9-1.2; 0.319) 145 251 cases compared 252 more cases. Conclusions clear association undergoing where less per year performed. study results could help practitioners guide potential perform reduce overall complication rates. Furthermore, this underscores importance minimum threshold arthroplasty get permission arthroplasty. Level Evidence III, therapeutic study.