|Dr. Brett Greenky|
Increasingly patients are accessing health care services to increase mobility, functionality, and pain-free lifestyle choices through joint replacement services. This year more than 560,000 knee replacements and over 400,000 hip replacements will be performed in the United States alone. As our population ages, becomes more active and in some cases heavier, the need for joint replacement surgery is expected to increase over 300% in the next decade! Where should you go to get fixed? Data is available to help you make an informed decision.
Consider these facts:
10 years ago, 60% of knee replacements were performed by surgeons who did less than 30 cases per year and in institutions that performed less than 100 cases per year.
Currently there is a strong trend towards specialization in the delivery of hip and knee replacement services. Select hospitals that perform more than a 1000 cases per year are emerging. These institutions and the surgeons who work there have dramatically better results and lower complication rates when compared to the nonspecialized hospitals and surgeons.
Studies over and over have shown lower pneumonia, urinary tract infection, deep infection, heart attacks, and blood clot rates after joint replacement surgery performed in these institutions. They all show the same thing: experience breeds excellence. The more experience, the bigger the gap in performance over the low volume centers.
See for yourself:
1. Journal of Bone and Joint Surgery (JBJS) 2004. 95-99% confidence levels are exhibited; high volumes equal lower risks and better results.
2. JBJS 2004. At the Brigham Hospital in Boston, surgeons doing less than 25 cases per year did 11% of the knee replacements but had problems at a rate twice as high as surgeons who do more than 100 cases per year.
3. JBJS 2004. 81,000 Medicare patients were reviewed and results were superior in cases performed by surgeons with volumes above 50/ year compared with those done by surgeons with less than 12/ year.
4. JBJS 2006. High volume surgeons superior results seem to benefit all patients, but especially those with co-morbidities (that means lots of other medical issues that could complicate an otherwise routine procedure).
5. JBJS 2010. High volume surgeons and institutions provided care with lower rates of readmission, shorter lengths of stay in the hospital, more common discharge to home versus a rehab center, and lower risks of bleeding, infection, blood clots and pneumonia.
6. The Proceedings of the Knee Society 2010. High surgical volumes increase the likelihood of positive patient outcomes.
Higher volumes equal superior results---Period.
It is becoming clearer that super high volumes are even better than high volumes. Major joint replacement centers are emerging in many of America's major cities. Hospitals that perform more than 1000 joint replacements per year are now available. These centers have established treatment protocols which streamline care and give reliable and reproducible results. There is little doubt that these centers and the corresponding surgeon staff will have the most experience in providing surgery services and exceptional patient outcomes.
We are fortunate in our community to have one of these centers: St Joseph's Hospital Health Center. St. Joe’s performed nearly 1400 joint replacement surgeries in 2010, the most of any hospital in Central New York. Indeed, data from 2004-2005 suggests 46% of ALL of Central New York joint replacement operations are performed at St Joe's! The team at SJH, headed by Drs. Seth and Brett Greenky is proud of our elite program and is dedicated to not only maintain an outstanding level of care, but to seek continuous improvement.