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General Joint Surgery Information
The Number of Surgeries Performed by
a Given Doctor Can Affect the Post-operative Complications
It seems reasonable that the more of a particular type of surgery
a doctor does the better he is at performing that surgery. In
fact, many of our new patients call and ask us how many joint
surgeries we perform to "screen" our doctors before
they make an appointment. (The answer is: about 1,200 annually.)
A recent study of over 5,000 total hip patients at more than
150 hospitals found that the single most important factor in
predicting complications was the volume of cases a doctor did.
If he did fewer than 10 per year, the number of dislocations
or infections his patients suffered was significantly higher
than for a surgeon who did more than 10 per year. Why is that
an issue? Another report has stated that half of the total hip
surgeries done in this country each year are done by surgeons
who do fewer than 20 per year.
The reasons for the difference in complications in high volume
vs. low volume practices are not always obvious. It is not that
a doctor doing only a few total hips is a bad surgeon. Experience
helps with early detection of problems, but it also means that
the surgeon has "seen it all" and can avoid techniques
or tools that might lead to a problem after surgery for an unusual
case. High volume also means that the surgeon is more likely
to finish the case faster, and the faster a wound is closed,
the less chance of infection.
Not all of the factors are under the doctor’s control. High
volume means that the hospital is more likely to have all the
necessary tools and staff that know all about total hip surgery,
thus preventing problems before, during and after the surgery
when the nursing staff is taking care of the patient. (One of
our operating room nurses has been doing total joint surgery
with this practice for 20 years.) And, patients who have more
medical problems tend to have more complications regardless
of the surgeon’s or hospital’s volume.
The surgeons at TCJR specialize in total joint surgery because
they enjoy the challenge that it poses and they know that the
more they do the better they are and the better the outcome
for all patients.
Excerpted from Orthopedics Vol. 25 No. 11 Nov. 2002 pg 1283-1287
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