Association between annual hospital volume and outcome in revision total hip arthroplasty; do high volume centres perform better? An exploratory analysis based on the LROI
Approval date: September 2023
Starting date: January 9th 2024
B van Dooren, R Peters, BW Schreurs, LN van Steenbergen, M Vink, WP Zijlstra
Research proposal abstract
As the incidence of THA rises and the life expectancy improves, there is a growing concern regarding the incidence of complications and the subsequent need for revision surgery. Simultaneously, a trend is seen towards super specialization and centralization for all fields of orthopaedic surgery, especially for technically demanding or less frequently performed procedures. Previous studies have demonstrated that
centralization and thereby increasing hospital volume, is proven effective in reducing morbidity and mortality rates after primary THA. In addition, the relation between annual volume and revision rates have previously been described for primary THA. However, little is known regarding the volume-outcome relationship in revision THA. In particular, there is a lack of studies using nationwide data.
The aim of this study is to investigate the association between annual hospital volume for revision THA and re-revision surgery as well as mortality. Moreover, we examine type and reasons for re-revision surgery according to hospital volume with special focus on revision for infection. We hypothesize that an increased volume of revision THA procedures performed in a hospitals is associated with a lower risk of second revision surgery.