Evidence map›Paper›PMID 41785394›Full record

ArticleActa orthopaedica2026

Associations between hospital characteristics, volume, and reasons for revision: a cohort study of 48,029 unicompartmental knee arthroplasties with 3,397 revisions from the Dutch Arthroplasty Register.

Hendrik W H De Raadt, Iris Koenraadt-van Oost, Anouk Nijs, Anneke Spekenbrink-Spooren, Leon Elmans, Rutger C I Van Geenen

Abstract read
In one paragraph

Article in Acta orthopaedica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Hendrik W H De RaadtFoundation for Orthopedic Research, Care & Education, Amphia Hospital, Breda; Department of Orthopedic Surgery, Amphia Hospital, Breda, the Netherlands. hendrikderaadt@gmail.com.
Iris Koenraadt-van OostFoundation for Orthopedic Research, Care & Education, Amphia Hospital, Breda, the Netherlands.ORCID 0000-0002-7580-7349
Anouk NijsFoundation for Orthopedic Research, Care & Education, Amphia Hospital, Breda, the Netherlands.
Anneke Spekenbrink-SpoorenDutch Arthroplasty Register (LROI), 's-Hertogenbosch, the Netherlands.
Leon ElmansDepartment of Orthopedic Surgery, Amphia Hospital, Breda, the Netherlands.
Rutger C I Van GeenenDepartment of Orthopedic Surgery, Amphia Hospital, Breda, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeIt remains debated whether high annual hospital volumes for unicompartmental knee arthroplasty (UKA) are associated with a low risk of revision, and what explanations may underlie this relationship. We aimed to analyze the association between specific hospital characteristics defined as volume, type, and referral for revision, and frequency and reasons for UKA revision.

methodsData from primary UKAs (2007-2022) and their revisions were extracted from the Dutch Arthroplasty Register. Hospitals were categorized by type; academic, top clinical teaching, private, or other general hospitals. Hospitals were grouped by annual UKA volume: ≤24, 25-39, 40-79, and ≥80 procedures. Multiple linear regression assessed the relationship between the number of revisions with hospital volume and type, adjusted for confounders. Chi-squared tests were used to test for differences in revision reasons based on volume and referrals.

results48,029 primary UKAs and 3,397 revisions were included. High-volume and top clinical teaching hospitals had a significantly lower risk of revision following primary UKA (P < 0.001). Cementless implants had a lower risk compared with cemented implants. Revision reasons varied by hospital volume and whether revision occurred after referral (P < 0.001). Loosening, progression of osteoarthritis, malalignment, and pain were less common in the highest volume hospitals. If revision occurred after referral, malalignment was more frequently registered as the reason for revision.

conclusionHigh-volume and top clinical teaching hospitals were associated with lower risk of revision following primary UKA. Differences in revision reasons, with fewer cases of loosening, progression of osteoarthritis, malalignment, and pain, may explain the lower risk of revision at higher volume hospitals.

Indexed as

Arthroplasty, Replacement, KneeHospitalsHospitals, High-VolumeHospitals, Low-VolumeReoperationAgedCohort StudiesFemaleHumansKnee ProsthesisMaleMiddle AgedNetherlandsProsthesis FailureRegistries

Identifiers

PMID41785394
PMCPMC12963959

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