Key to Better Knee Replacement Outcomes: An Experienced Surgeon

The Hospital for Special Surgery in New York published data on meaningful surgeon and hospital volume thresholds in the October, 2016 Journal of Bone and Joint Surgery.

Surgeon volume of 60 or more cases per year had the best 90 day complication and 2 year revision rates. Choose a surgeon that performs 5 or more knee joint replacement surgeries per month.

Facility volume of 236 cases per year had lower 90 complication rates.  Mortality rates were lowest for facilities performing more than 645 cases per year.

An analysis of 182,146 patients undergoing primary total hip and knee replacement concludes higher surgeon volume was associated with lower rates of readmission and reoperation, shorter length of hospital stay and higher likelihood of being discharged to home (JBJS November 17, 2010). Higher hospital volume was associated with lower risk of mortality and readmission and higher likelihood of being discharged home.

The process of standardization- adhering to evidence based processes of care resulted in improved clinical outcomes and shorter length of hospital stay, independent of surgeon or hospital volume. Annual surgeon volume high to low in quartiles is 278, 127, 62 and 24 cases per year. Annual hospital volume high to low in quartiles is 1007, 604,361 and 181 cases per year.