Dislocation is a Leading Cause of Decreased Survival Rate in Primary Total Hip Arthroplasty Performed by Low-Volume Surgeons: Long-Term Retrospective Cohort Study |
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| Institution: | 1. Department of Rheumatology, Japanese Red Cross Tottori Hospital, Tottori, Japan;2. Department of Orthopedic Surgery, Japanese Red Cross Tottori Hospital, Tottori, Japan;3. Department of Rehabilitation, Japanese Red Cross Tottori Hospital, Tottori, Japan;1. Chapel Hill Orthopedics Surgery & Sports Medicine, Chapel Hill, NC;2. Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medical Center, Chicago, IL;1. Department of Orthopedic Surgery, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan;2. Department of Orthopedic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;1. Orthopaedic Department, Oslo University Hospital, Radiumhospitalet, N-0027 Oslo, Norway;2. Orthopaedic Department, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway;1. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL;2. Department of Orthopaedic Surgery, University of Wisconsin-Madison, Madison, WI;3. Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY;4. Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, Philadelphia, PA;5. Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY |
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| Abstract: | BackgroundThis study aimed to evaluate the complications and long-term survival of primary total hip arthroplasty (THA) performed by low-volume (LV) surgeons at a LV hospital. We also determined the relationship between complications and revisions.MethodsThis retrospective cohort study included 220 THAs in 194 patients treated at our institution between 1998 and 2008, who received a minimum of a 10-year follow-up. The median annual THA volume at this hospital was 23 procedures (range, 11-32), and the annual volume per surgeon ranged from 1 to 19. We investigated the 90-day mortality and rates of periprosthetic joint infections, dislocations, and periprosthetic fractures up to the last visit (median follow-up, 11.8 years). Kaplan-Meier survival was calculated with revision as the end point.ResultsPostoperative infections, dislocations, and fractures at any time during the follow-up period were reported for 1 hip (0.5%), 23 hips (9.8%), and 4 hips (1.8%), respectively. One death occurred within the first 90 days postoperatively. Fifteen hips required revision surgery, and the survival rate was 95.5% at 5 years and 94.1% at 10 years. Of 10 hips that required early revision surgery within 5 years after the index surgery, 9 were revisions to address recurrent dislocation.ConclusionThe risk of dislocation was high. A high number of patients who underwent THA by LV surgeons required early revision because of dislocation. To achieve optimal long-term survivorship, LV surgeons should consider measures to reduce the risk of dislocation. |
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| Keywords: | primary total hip arthroplasty surgeon volume complication dislocation survival rate |
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