ArticlePloS one2019
Should we pay attention to surgeon or hospital volume in total knee arthroplasty? Evidence from a nationwide population-based study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- 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
- 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
- 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
- Racial Disparities in Elective Total Joint Arthroplasty for Osteoarthritis.ACR open rheumatology · 2022Review
- Highlights of the 2021 American Joint Replacement Registry Annual Report.Arthroplasty today · 2022Article
- How much is enough for total knee arthroplasty?BMJ surgery, interventions, & health technologies · 2021Article
- How much is enough? Finding the minimum annual surgical volume threshold for total knee replacement.BMJ surgery, interventions, & health technologies · 2021Article
- [Influence of institutional experience on results in hip and knee total arthroplasty : An analysis from the German arthroplasty registry (EPRD)].Der Orthopade · 2020Article
- Total Hip Arthroplasty for Developmental Dysplasia of Hip vs Osteoarthritis: A Propensity Matched Pair Analysis.Arthroplasty today · 2020Article
- Is Treatment at a High-volume Center Associated with an Improved Survival for Primary Malignant Bone Tumors?Clinical orthopaedics and related research · 2020Article
- Do We Get What We Pay For? Examining the Relationship Between Payments and Clinical Outcomes in High-Volume Elective Surgery in a Commercially-Insured Population.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough prior research into the relationship between volume and outcome indicates that this relationship is not linear and that an optimal volume should be specified, consensus is lacking regarding the ideal value of this optimal volume. The purposes of this study were to use a visual method to identify surgeon- and hospital-volume thresholds and to examine the relationships of surgeon and hospital volume thresholds to 30-day readmission.
methodsA retrospective nationwide population-based study design was adopted. Patients who received total knee replacement surgery between 2007 and 2008 in any hospital in Taiwan were included. After adjusting for patient, physician, and hospital characteristics, a restricted cubic spline regression model was used to identify optimal surgeon- and hospital-volume thresholds. Further, a patient-level mixed effect model was conducted to test the respective relationships between these thresholds and 30-day readmission.
resultsA total of 30,828 patients who had received their surgeries from 1,468 surgeons in 437 hospitals were included in this study. Thresholds of 50 cases a year for surgeons and 75 cases a year for hospitals were identified using a restricted cubic spline regression model. However, only the surgeon volume threshold was associated with 30-day readmission using a patient-level mixed effect model after adjusting for patient-, surgeon- and hospital-level covariates.
conclusionsAccording to the results of the restricted cubic spline models, the optimal volume thresholds for surgeons and hospitals are 50 cases and 75 cases a year, respectively. However, only the surgeon volume threshold is associated with 30-day readmission.
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