SynthesisBMC musculoskeletal disorders2012
The role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature.
Synthesis in BMC musculoskeletal disorders, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
85 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Hospital volume-outcome relationship in total knee arthroplasty: a systematic review and dose-response meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- Effect of hospital volume on outcomes of total hip arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2019Pooled it
- The impact of surgeon volume on patient outcome in spine surgery: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Pooled it
- Relationship between surgeon volume and outcomes: a systematic review of systematic reviews.Systematic reviews · 2016Pooled it
- Impact of centre volume, surgeon volume, surgeon experience and geographic location on reoperation after intramedullary nailing of tibial shaft fracturesCanadian journal of surgery. Journal canadien de chirurgie · 2021Trial
- Migration and clinical outcome of mobile-bearing versus fixed-bearing single-radius total knee arthroplasty.Acta orthopaedica · 2018Trial
- Robotic-assisted total knee arthroplasty is associated with more favorable early patient-reported outcomes and may attenuate experience-related outcome differences.Journal of robotic surgery · 2026Article
- Beyond Precision: Why the Future of Robotic Joint Arthroplasty Demands Continued Research.Arthroplasty today · 2026Article
- Robotic-assisted arthroplasty paradox: the disconnect between precision and patient-perceived outcomes.Bone & joint open · 2026Article
- Robotic Assistance for Low-Volume Total Knee Arthroplasty Surgeons Is Associated With Comparable Perioperative Outcomes Related to Those of High-Volume Surgeons Using Conventional Techniques.Arthroplasty today · 2026Article
- Mid-term outcome of elbow hemiarthroplasty performed in a tertiary elbow hub.Shoulder & elbow · 2026Article
- Investigating non-linear volume-outcome relationships in total knee arthroplasty based on a sample of more than 60,000 hospital cases from Germany, 2020-2023.Scientific reports · 2026Article
- A Novel Preoperative Calculator for 90-Day Prosthetic Joint Infection Following Total Joint Arthroplasty Based off the Michigan Arthroplasty Registry Collaborative Quality Initiative Database.Arthroplasty today · 2026Article
- Exploring the optimal age for total knee arthroplasty to minimize risk of adverse outcomes: machine learning analysis of a statewide cohort.Arthroplasty (London, England) · 2026Article
- Motivations and factors influencing the choice of a career as a thoracic surgeon in Japan: results of a nationwide questionnaire survey.Surgery today · 2026Article
- Robotic-Assisted Primary Total Knee Arthroplasty is Associated With Decreased 90-Day Opioid Prescribing Patterns Compared to Manual Instrumentation.Arthroplasty today · 2025Article
- Patellofemoral arthroplasty in isolated Iwano grade IV patellofemoral osteoarthritis: 86% 10-year survival.Journal of experimental orthopaedics · 2025Article
- CORR Synthesis: What Is the Role of Robotic-assisted Technology in Knee Arthroplasty?Clinical orthopaedics and related research · 2025Article
- Article
- Article
25 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA number of factors have been identified as influencing total knee arthroplasty outcomes, including patient factors such as gender and medical comorbidity, technical factors such as alignment of the prosthesis, and provider factors such as hospital and surgeon procedure volumes. Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of total joint arthroplasty to higher volume centers, and adoption of volume standards. To contribute to the discussions concerning the optimization of provider factors and proposals to regionalize total knee arthroplasty practices, we undertook a systematic review to investigate the association between surgeon volume and primary total knee arthroplasty outcomes.
methodsWe performed a systematic review examining the association between surgeon volume and primary knee arthroplasty outcomes. To be included in the review, the study population had to include patients undergoing primary total knee arthroplasty. Studies had to report on the association between surgeon volume and primary total knee arthroplasty outcomes, including perioperative mortality and morbidity, patient-reported outcomes, or total knee arthroplasty implant survivorship. There were no restrictions placed on study design or language.
resultsStudies were variable in defining surgeon volume ('low': <3 to <52 total knee arthroplasty per year; 'high': >5 to >70 total knee arthroplasty per year). Mortality rate, survivorship and thromboembolic events were not found to be associated with surgeon volume. We found a significant association between low surgeon volume and higher rate of infection (0.26% - 2.8% higher), procedure time (165 min versus 135 min), longer length of stay (0.4 - 2.13 days longer), transfusion rate (13% versus 4%), and worse patient reported outcomes.
conclusionsFindings suggest a trend towards better outcomes for higher volume surgeons, but results must be interpreted with caution.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.