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Knee News

Importance of Hospital Volume in Results of Total Knee Replacement

Past studies have shown that surgeons who do more total knee replacements (TKRs) have the best results. This study looks at hospital volume in a similar way. Results showed that death rates and rates of infection are lower in hospitals with a high volume of TKRs. Other factors linked with poor outcomes are also reported.

Data for over 200,000 TKRs done in California over a 10-year period of time was used in this study. Researchers were looking for significant predictors of complications. Factors reviewed included patient age, gender (male or female), and type of insurance. Volume of patients treated in each hospital was also considered.

The results showed that age and health problems were linked with death rate. Both of these factors were more likely to result in higher infection rates leading to death. Age was also a risk factor for fatal blood clots to the lungs. Blacks and Hispanics were more likely to have blood clots and infections.

Medicare patients and patients at low-volume hospitals had the highest rate of complications after TKR. The authors say this information will help low-volume hospitals improve the quality of care and results after TKR. Future studies focusing on success factors in high volume hospitals should be the next step. Low volume hospitals may be able to use some of the methods used by high volume facilities.


Nelson F. SooHoo, MD, et al. Factors Predicting Complications Rates Following Total Knee Replacement. In The Journal of Bone and Joint Surgery. March 2006. Vol. 88-A. No. 3. Pp. 480-485.

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