The pain in your knee is getting unbearable, and you have decided to go for a knee replacement. But where would you do it? Which is the best hospital?
Quite a number of studies have shown that the success rate of knee replacement surgery depends strongly on the volume of knee replacement patients treated at the hospital at which the procedure is done.
Being treated at a hospital with a high patient volume can substantially increase the success rate of knee replacement surgery.
The outcomes of knee replacement surgery are often evaluated by a measure called the WOMAC Index (WOMAC is an acronym for Western Ontario and McMaster Universities Arthritis Index). A poor WOMAC index score means that the knee replacement does not function properly and patients experience significant pain, discomfort, and motion limitations.
The percentage of patients with poor WOMAC Index scores after knee replacement surgery is more than twice as large at low volume hospitals than it is at high volume hospitals. Therefore, choosing a high volume hospital for the procedure can substantially increase the chances of a successful knee replacement.
Within a high volume hospital, it is best to choose a high volume orthopedic surgeon to perform the procedure.
The table below lists 99 hospitals ordered by a measure of their volume of knee replacement surgery patients: high volume hospitals are at the top of the table, and the volume declines down the table. The best hospitals are the ones at the top of the table.
As you can see from the table, the number of hospitals with large patient volume is relatively small; they are mostly located in states like New York, Pennsylvania, Indiana, Texas, Massachusetts, Minnesota, NJ, California, North Carolina, Maryland, Illinois, and Michigan. If your health insurance covers it, it is best to travel to one of the top twenty or so hospitals on this list (the hospitals listed on the first page of the table below). Otherwise, if you are limited to using hospitals included in the bottom 50 on this table, think twice. The risk of undesirable outcomes is high.
|hospital||location||measure of patient volume|
|Hospital for Joint Diseases||New York, NY||100|
|Hospital for Special Surgery||New York, NY||67|
|Thomas Jefferson University Hospital||Philadelphia, PA||51|
|IU Health Academic Health Center||Indianapolis, IN||45|
|Houston Methodist Hospital||Houston, TX||45|
|New England Baptist Hospital||Boston, MA||43|
|Allina Abbott Northwestern Hospital||Minneapolis, MN||39|
|Hackensack University Medical Center||Hackensack, NJ||37|
|Massachusetts General Hospital||Boston, MA||37|
|Mayo Clinic||Rochester, MN||35|
|Stanford Hospital and Clinics||Palo Alto, CA||35|
|Duke University Medical Center||Durham, NC||34|
|Johns Hopkins Hospital||Baltimore, MD||32|
|Advocate Good Samaritan Hospital||Downers Grove, IL||31|
|Baylor University Medical Center||Dallas, TX||30|
|Brigham and Women’s Hospital||Boston, MA||29|
|Beaumont Hospital||Royal Oak, MI||29|
|UCLA Medical Center||Los Angeles, CA||29|