SynthesisJournal of orthopaedic surgery and research2019
Effect of hospital volume on outcomes of total hip arthroplasty: a systematic review and meta-analysis.
Synthesis in Journal of orthopaedic surgery and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 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
39 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The effect of surgeon volume on outcomes after total hip arthroplasty: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2026Pooled it
- Evidence-Supported HBO Therapy in Femoral Head Necrosis: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2021Pooled it
- High-Volume Hospitals Are Associated With Lower Rates of Mortality Following Revision Arthroplasty for Periprosthetic Joint Infection.Arthroplasty today · 2026Article
- Hospital-Wide Safety Performance Affects Complication Rates After Primary Total Hip and Knee Arthroplasty.Arthroplasty today · 2026Article
- Variation in patient-reported outcomes after total hip replacement across ten high-volume hospitals in Germany: results from a multicenter, prospective, longitudinal Cohort Study.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Impact of Rurality on Total Joint Arthroplasty Access and Outcomes: A Systematic Review.Arthroplasty today · 2026Review
- Combining forces in dual certified centers of geriatric trauma/joint replacement according to the German trauma society (DGU)/endocert improves mobility and quality of life in elderly patients with femoral neck fractures: an analysis from the registry for geriatric trauma (ATR-DGU).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Regionalization of Hip Fracture Care in Five High-Income Countries.Health services research · 2025Article
- Time to Total Hip Arthroplasty Among Patients in the US Military Health System.JAMA network open · 2025Article
- High-volume day-case hip arthroplasty in a district general hospital.Bone & joint open · 2025Article
- Learning Curves Associated With Robotic Total Hip Arthroplasty: A Scoping Review.Orthopaedic surgery · 2025Article
- Treatment decisions and surgery variables are predictors of better physical function after total hip and knee arthroplasty: a retrospective cohort study.Arthroplasty (London, England) · 2025Article
- The elicitation of patient preferences for hip replacement surgery: a discrete choice experiment.BMC health services research · 2025Article
- What Are the Relative Associations of Surgeon Performance and Prosthesis Quality With THA Revision Rates?Clinical orthopaedics and related research · 2025Article
- Is the treatment of ankle osteoarthritis changing over time in Italy? Analysis of temporal trends for fusion and arthroplasty in a population-based study from 2001 to 2022 on the National Hospital Discharge Record database.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Article
- Analysing the intra and interregional components of spatial accessibility gravity model to capture the level of equity in the distribution of hospital services in Italy: do they influence patient mobility?BMC health services research · 2024Article
- Institutional Surgical Setting and Volume Effects of Certified Arthroplasty Centers in Germany: Evaluation of the Quality of Care in a 5-Year Comparison.Healthcare (Basel, Switzerland) · 2024Article
- Does preoperative opioid use predict outcomes to 6 months following primary unilateral knee or hip arthroplasty for osteoarthritis? A data-linked retrospective study.Arthroplasty (London, England) · 2024Article
- Most Military Arthroplasty Surgeons Have a Low Volume Practice in the Military Health System.Arthroplasty today · 2024Article
- 'On Table' Versus 'Off Table' Direct Anterior Approach Total Hip Arthroplasty: Is There a Difference?Arthroplasty today · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA shift in the healthcare system towards the centralization of common yet costly surgeries, such as total hip arthroplasty (THA), to high-volume centers of excellence, is an attempt to control the economic burden while simultaneously enhancing patient outcomes. The "volume-outcome" relationship suggests that hospitals performing more treatment of a given type exhibit better outcomes than hospitals performing fewer. This theory has surfaced as an important factor in determining patient outcomes following THA. We performed a systematic review with meta-analyses to review the available evidence on the impact of hospital volume on outcomes of THA. MATERIALS AND
methodsWe conducted a review of PubMed (MEDLINE), OVID MEDLINE, Google Scholar, and Cochrane library of studies reporting the impact of hospital volume on THA. The studies were evaluated as per the inclusion and exclusion criteria. A total of 44 studies were included in the review. We accessed pooled data using random-effect meta-analysis.
resultsResults of the meta-analyses show that low-volume hospitals were associated with a higher rate of surgical site infections (1.25 [1.01, 1.55]), longer length of stay (RR, 0.83[0.48-1.18]), increased cost of surgery (3.44, [2.57, 4.30]), 90-day complications (RR, 1.80[1.50-2.17]) and 30-day (RR, 2.33[1.27-4.28]), 90-day (RR, 1.26[1.05-1.51]), and 1-year mortality rates (RR, 2.26[1.32-3.88]) when compared to high-volume hospitals following THA. Except for two prospective studies, all were retrospective observational studies.
conclusionsThese findings demonstrate superior outcomes following THA in high-volume hospitals. Together with the reduced cost of the surgical procedure, fewer complications may contribute to saving considerable opportunity costs annually. However, a need to define objective volume-thresholds with stronger evidence would be required.
trial registrationPROSPERO CRD42019123776.
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