Battaglia Todd C, Mulhall Kevin J, Brown Thomas E, Saleh Khaled J
Department of Orthopaedic Surgery, University of Virginia Health Sciences Center, Charlottesville, VA, USA.
Clin Orthop Relat Res. 2006 Jun;447:28-33. doi: 10.1097/01.blo.0000218743.99741.f0.
The presumed correlation between an increasing volume of health care procedures and an improvement in outcomes is sometimes referred to as the practice-makes-perfect effect. Growing interest in outcomes-based research has led to numerous papers examining this relationship for various surgical procedures, including total hip arthroplasty. The results of these studies have important implications for consumers, providers, and healthcare financers. Accordingly, we review the literature to date examining surgeon and hospital volume effects on hip arthroplasty outcomes, with a specific focus on the effects of volume on dislocation. A systemic review of the literature demonstrates a substantial positive association between surgical volumes and improvement in most THA outcomes, including dislocation; that is, increasing surgical volume is associated with lower dislocation rates. This correlation appears to be stronger and is more clearly established for surgeon volumes than it is for hospital volumes.
医疗保健程序数量的增加与治疗效果改善之间的假定关联有时被称为熟能生巧效应。对基于结果的研究的兴趣日益浓厚，促使大量论文探讨了各种外科手术（包括全髋关节置换术）中的这种关系。这些研究结果对消费者、医疗服务提供者和医疗保健资助者具有重要意义。因此，我们回顾了迄今为止关于外科医生手术量和医院手术量对髋关节置换术效果影响的文献，特别关注手术量对脱位的影响。对文献的系统综述表明，手术量与大多数全髋关节置换术效果（包括脱位）的改善之间存在显著的正相关；也就是说，手术量的增加与较低的脱位率相关。这种相关性在外科医生手术量方面似乎更强且更明确，相比医院手术量而言。
