Performing Revision Arthroplasty Increases Surgeon and Practice Volumes Through the Generation of Subsequent Cases: A Retrospective Study

Abstract

BackgroundRevision knee (TKR) and hip (THR) arthroplasty surgeries are disincentivized due to unfavorable reimbursement rates, surgical times, and complication rates. Our study aims to demonstrate the secondary benefits of performing these surgeries by generating subsequent cases for orthopaedic surgeons and practices. MethodsThis retrospective study analyzed patients undergoing TKR and THR between April 1, 2011, and January 1, 2019, at our tertiary academic institution. Patients were identified with Current Procedural Terminology codes for TKR and THR. We calculated a subsequent surgery rate on the same or different joint by the initial surgeon or another surgeon within the practice to determine the procedure yield after initial revision arthroplasty. ResultsOne thousand six hundred twenty-five patients underwent an initial TKR or THR. Six hundred forty-nine (39.9%) patients received at least one subsequent procedure on any joint by any orthopaedic surgeon in the practice. Four hundred five patients (24.9%) received a subsequent procedure on any joint by the same surgeon. Two hundred sixty patients (16.0%) received a subsequent procedure on the same joint by the same surgeon, with 109 cases (41.9%) being a planned second stage of a 2-stage revision for infection. Two hundred eighty-five patients (17.5%) received a subsequent procedure on a different joint by the same surgeon, with 122 of these patients (42.8%) undergoing at least one primary total hip arthroplasty or total knee arthroplasty. ConclusionsDespite potential disincentives to performing TKR and THR, these cases can increase surgeon and practice volumes through the generation of future cases, which are primarily the second stage of a 2-stage revision or primary joint arthroplasties on other joints.