Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Feb;27(2):278-285.e2.
doi: 10.1016/j.arth.2011.04.043. Epub 2011 Jul 12.

Long-term trends in hip arthroplasty use and volume

Peter Cram  1 , Xin Lu, John J Callaghan, Mary S Vaughan-Sarrazin, Xueya Cai, Yue Li
Affiliations

Long-term trends in hip arthroplasty use and volume

Peter Cram et al. J Arthroplasty. 2012 Feb.

Abstract

We used Medicare administrative data to examine trends in primary and revision total hip arthroplasty (THA) use and hospital volume. Between 1991 and 2005, primary and revision THA use increased by 40.9% and 16.8%, respectively. The percentage of primary THA procedures performed in high-volume hospitals (those in the highest quintile of volume) increased slightly from 58.0% of all procedures in 1991 to 58.7% in 2005 (P < .01). The percentage of revisions performed in high-volume hospitals increased from 60.9% to 62.4% (P < .01). The percentage of primary THA procedures performed by low-volume hospitals remained relatively stable (P = .36), whereas the percentage of revision THA performed by low-volume hospitals declined (P < .001). In aggregate, these results suggest minimal evidence that regionalization of THA is occurring.

PubMed Disclaimer

Conflict of interest statement

COMPETING INTERESTS:

The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The funding sources had no role in the analyses or drafting of this manuscript. None of the authors have any conflicts of interest. Dr. Cram has received consulting fees from The Consumers Union (publisher of Consumer Reports Magazine) and Vanguard Health Inc. for work advice on quality improvement initiatives. Dr. Callaghan is the President of the American Academy of Orthopaedic Surgery and has served as a consultant to several orthopaedic implant manufacturers.

Figures

Figure 1
Figure 1
Primary and revision Medicare THR volume 1991–2005
Figure 2
Figure 2
Primary and revision Medicare THR utilization per 10,000 enrollees per-year 1991–2005
Figure 3
Figure 3
A AND 3B: Primary and revision Hospital THR volume 1991–2005
Figure 3
Figure 3
A AND 3B: Primary and revision Hospital THR volume 1991–2005
Figure 4
Figure 4
Proportion of total primary THR procedures performed in high volume and low volume hospitals
Figure 5
Figure 5
Proportion of total revision THR procedures performed in high volume and low volume hospitals
Appendix A
Appendix A
Proportion of total primary THR procedures performed in high volume and low volume hospitals (all patients)
Appendix B
Appendix B
Proportion of total revision THR procedures performed in high volume and low volume hospitals (all patients)
Appendix C
Appendix C
Proportion of total primary THR procedures performed in high volume and low volume hospitals (fixed thresholds)
Appendix D
Appendix D
Proportion of total revision THR procedures performed in high volume and low volume hospitals
See this image and copyright information in PMC

References

    1. Merx H, Dreinhofer K, Schrader P, et al. International variation in hip replacement rates. Annals of the Rheumatic Diseases. 2003 Mar;62(3):222–226. - PMC - PubMed
    1. Lohmander LS, Engesaeter LB, Herberts P, Ingvarsson T, Lucht U, Puolakka TJ. Standardized incidence rates of total hip replacement for primary hip osteoarthritis in the 5 Nordic countries: similarities and differences. Acta Orthop. 2006 Oct;77(5):733–740. - PubMed
    1. Centers for Disease Control and Prevention. Health, United States, 2009. U.S. Centers for Disease Control; 2009.
    1. Khatod M, Inacio M, Paxton EW, et al. Knee replacement: epidemiology, outcomes, and trends in Southern California: 17,080 replacements from 1995 through 2004. Acta Orthop. 2008 Dec;79(6):812–819. - PubMed
    1. Katz JN, Phillips CB, Baron JA, et al. Association of hospital and surgeon volume of total hip replacement with functional status and satisfaction three years following surgery. Arthritis & Rheumatism. 2003 Feb;48(2):560–568. [see comment] - PubMed