Toggle Main Menu Toggle Search

Open Access padlockePrints

Consultant revision hip arthroplasty volumes and new consultant volume trajectories in England, Wales, Northern Ireland, and the Isle of Man

Lookup NU author(s): Dr Richard Holleyman, Dr Simon Jameson

Downloads


Licence

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Abstract

© 2023 Holleyman et al. Aims: This study describes the variation in the annual volumes of revision hip arthroplasty (RHA) undertaken by consultant surgeons nationally, and the rate of accrual of RHA and corresponding primary hip arthroplasty (PHA) volume for new consultants entering practice. Methods: National Joint Registry (NJR) data for England, Wales, Northern Ireland, and the Isle of Man were received for 84,816 RHAs and 818,979 PHAs recorded between April 2011 and December 2019. RHA data comprised all revision procedures, including first-time revisions of PHA and any subsequent re-revisions recorded in public and private healthcare organizations. Annual procedure volumes undertaken by the responsible consultant surgeon in the 12 months prior to every index procedure were determined. We identified a cohort of ‘new’ HA consultants who commenced practice from 2012 and describe their rate of accrual of PHA and RHA experience. Results: The median annual consultant RHA volume, averaged across all cases, was 21 (interquartile range (IQR) 11 to 34; range 0 to 181). Of 1,695 consultants submitting RHA cases within the study period, the top 20% of surgeons by annual volume performed 74.2% of total RHA case volume. More than half of all consultants who had ever undertaken a RHA maintained an annual volume of just one or fewer RHA, however, collectively contributed less than 3% of the total RHA case volume. Consultant PHA and RHA volumes were positively correlated. Lower-volume surgeons were more likely to undertake RHA for urgent indications (such as infection) as a proportion of their practice, and to do so on weekends and public holidays. Conclusion: The majority of RHAs were undertaken by higher-volume surgeons. There was considerable variation in RHA volumes by indication, day of the week, and between consultants nationally. The rate of accrual of RHA experience by new consultants is low, and has important implications for establishing an experienced RHA consultant workforce.


Publication metadata

Author(s): Holleyman RJ, Jameson SS, Reed M, Meek RMD, Khanduja V, Hamer A, Judge A, Board T

Publication type: Article

Publication status: Published

Journal: Bone and Joint Journal

Year: 2023

Volume: 105-B

Issue: 10

Pages: 1060-1069

Print publication date: 01/10/2023

Acceptance date: 02/04/2018

Date deposited: 03/11/2023

ISSN (print): 2049-4394

ISSN (electronic): 2049-4408

Publisher: British Editorial Society of Bone and Joint Surgery

URL: https://doi.org/10.1302/0301-620X.105B10.BJJ-2023-0311.R1

DOI: 10.1302/0301-620X.105B10.BJJ-2023-0311.R1

Data Access Statement: The datasets generated and analyzed in the current study are not publicly available due to data protection regulations. Access to data is limited to the researchers who have obtained permission for data processing. Further inquiries can be made to the National Joint Registry research team.

PubMed id: 37777199


Altmetrics

Altmetrics provided by Altmetric


Funding

Funder referenceFunder name
544
British Hip Society
Orthopaedic Research UK

Share