Increased Surgical Volume Is Associated with Lower THA Dislocation Rates

The presumed correlation between an increasing volume of health care procedures and an improvement in outcomes is sometimes referred to as the practice-makes-perfect effect. Growing interest in outcomes-based research has led to numerous papers examining this relationship for various surgical procedures, including total hip arthroplasty. The results of these studies have important implications for consumers, providers, and healthcare financers. Accordingly, we review the literature to date examining surgeon and hospital volume effects on hip arthroplasty outcomes, with a specific focus on the effects of volume on dislocation. A systemic review of the literature demonstrates a substantial positive association between surgical volumes and improvement in most THA outcomes, including dislocation; that is, increasing surgical volume is associated with lower dislocation rates. This correlation appears to be stronger and is more clearly established for surgeon volumes than it is for hospital volumes.

Level of Evidence: Therapeutic study, level III (systematic review). See Guidelines for Authors for a complete description of levels of evidence.