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. 2023 Sep 19:23:101207.
doi: 10.1016/j.artd.2023.101207. eCollection 2023 Oct.

Are Patient Outcomes Affected by Surgeon Experience With Total Hip Arthroplasty in Morbidly Obese Patients?

Vinaya Rajahraman  1 , Ittai Shichman  1   2 , Emily Berzolla  1 , Joshua Rozell  1 , Morteza Meftah  1 , Ran Schwarzkopf  1
Affiliations

Are Patient Outcomes Affected by Surgeon Experience With Total Hip Arthroplasty in Morbidly Obese Patients?

Vinaya Rajahraman et al. Arthroplast Today. .

Abstract

Background: Surgeons with high volume (HV) of total hip arthroplasty (THA) have seen better outcomes than low volume (LV) surgeons. However, literature regarding surgeon volume and outcomes in morbidly obese THA patients is scarce. This study examines the association between surgeon volume with THA in morbidly obese patients (body mass index ≥40) and their clinical outcomes.

Methods: We retrospectively reviewed all morbidly obese patients who underwent primary THA at our institution between March 2012 and July 2020 with 2 years of follow-up. Clinical outcomes were compared between the HV (HVa, top quartile of surgeons with the highest overall yearly THA volume) and LV (LVa) surgeons. Similar analysis was run comparing HV of morbidly obese THA (HVo, top quartile of surgeons with the highest yearly morbidly obese THA volume) and LV of morbidly obese THA (LVo) surgeons.

Results: Six hundred and forty-three patients and 33 surgeons were included. HVa surgeons had significantly shorter length of stay and increased home discharge. HVa and HVo surgeons had significantly shorter operative times. There were no significant differences in overall 90-day major and minor complications or clinical differences in patient-reported outcomes. Revision rates and freedom from revisions did not differ between groups at 2-year follow-up.

Conclusions: HVa surgeons had significantly lower length of stay and operative times and increased discharge to home. There was no significant decrease in complications or revisions in either comparison model. Complications, revision rates, and patient satisfaction in morbidly obese patients who undergo THA may be independent of surgeon volume.

Keywords: Complications; Morbid obesity; Surgeon volume; THA.

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Figures

Figure 1
Figure 1
Kaplan-Meier curve showing freedom from all-cause revision over 2 years for high and low overall THA volume surgeon quartiles.
Figure 2
Figure 2
Kaplan-Meier curve showing freedom from aseptic revision over 2 years for high and low overall THA volume surgeon quartiles.
Figure 3
Figure 3
Kaplan-Meier curve showing freedom from all-cause revision over 2 years for high and low morbidly obese-specific THA volume surgeon quartiles.
Figure 4
Figure 4
Kaplan-Meier curve showing freedom from aseptic revision over 2 years for high and low morbidly obese-specific THA volume surgeon quartiles.
See this image and copyright information in PMC

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