ArticleActa orthopaedica2024
Time trends in case-mix and risk of revision following hip and knee arthroplasty in public and private hospitals: a cross-sectional analysis based on 476,312 procedures from the Dutch Arthroplasty Register.
Article in Acta orthopaedica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Change in bone mineral density after cemented and uncemented knee arthroplasty with an asymmetrical tibial component: secondary analysis of a randomized study using dual-energy X-ray absorptiometry.Acta orthopaedica · 2026Trial
- Article
- Postoperative delirium risk in elderly high-risk patients undergoing hip and knee arthroplasty (ASA Ⅲ-Ⅳ): construction and validation of a nomogram model based on frail frailty index.Frontiers in medicine · 2026Article
- Cost-effectiveness of robotic-assisted versus conventional total knee arthroplasty: an analysis from a middle income country.Acta orthopaedica · 2025Article
- High-volume hospitals do not perform better than low-volume hospitals in septic and aseptic revision total hip arthroplasty: an analysis of re-revision risk and mortality based on the Dutch Arthroplasty Register.Acta orthopaedica · 2025Article
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8 authors.
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Abstract
background and purposeThis study aims to assess time trends in case-mix and to evaluate the risk of revision and causes following primary THA, TKA, and UKA in private and public hospitals in the Netherlands.
methodsWe retrospectively analyzed 476,312 primary arthroplasties (public: n = 413,560 and private n = 62,752) implanted between 2014 and 2023 using Dutch Arthroplasty Register data. We explored patient demographics, procedure details, trends over time, and revisions per hospital type. Adjusted revision risk was calculated for comparable subgroups (ASA I/II, age ≤ 75, BMI ≤ 30, osteoarthritis diagnosis, and moderate-high socioeconomic status (SES).
resultsThe volume of THAs and TKAs in private hospitals increased from 4% and 9% in 2014, to 18% and 21% in 2022. Patients in private hospitals were younger, had lower ASA classification, lower BMI, and higher SES compared with public hospital patients. In private hospitals, age and ASA II proportion increased over time. Multivariable Cox regression demonstrated a lower revision risk for primary THA (HR 0.7, CI 0.7-0.8), TKA (HR 0.8, CI 0.7-0.9), and UKA (HR 0.8, CI 0.7-0.9) in private hospitals. After initial arthroplasty in private hospitals, 49% of THA and 37% of TKA revisions were performed in public hospitals.
conclusionPatients in private hospitals were younger, had lower ASA classification, lower BMI, and higher SES com-pared with public hospital patients. The number of arthroplasties increased in private hospitals, with a lower revision risk compared with public hospitals.
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