Total Knee Replacement Quality Measures
The number of surgeries performed at a hospital is easily
measured and has been used as a marker for clinical expertise. Procedure volume
(number of cases per hospital or surgeon) has therefore become a widely-used
quality indicator for surgery. However, some hospitals may have fewer procedures
performed per year and still have excellent outcomes.
A study of 80,904 Medicare
patients demonstrated that patients receiving primary (first time) total knee
replacement in higher-volume hospitals (hospitals with an annual volume exceeding
200 primary and revision total knee replacement procedures) generally have
lower rates of mortality, pneumonia, and deep knee infection than do patients
managed in lower-volume hospitals (hospitals with an annual volume of 25 primary
and revision total knee replacement procedures or fewer) (The
Journal of Bone and Joint Surgery, 2004: 86; 1909-1916).
Other important factors
associated with higher complication rates following total knee replacement
are advanced patient age and additional patient health problems (The
Journal of Bone and Joint Surgery, 2006; 88: 480-485).
St. Mary's Hospital Medical Center performed
223 total knee replacements (primary and revision) procedures in
2006.