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

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

• THA
• Morbid obesity
• Surgeon volume
• Complications