Introduction. We compared standard
Background. Improving quality and efficiency is a priority in health policy. Several studies have shown a correlation between high hospital volume and improved results of surgery. In Norway, orthopaedic surgeons operate a relatively low number of total knee replacements compared with other countries. The number of total knee replacements has, however, increased significantly over the past 10 years. Some studies have also shown an association between surgeon volume and outcomes after total knee arthroplasty (TKA). Purpose. We wanted to study a possible correlation between prosthesis survival and surgery volume of TKA, both with respect to hospital volume and surgeon volume. Materials and Methods. To examine the annual surgery volume per hospital we used registry data from the Norwegian Arthroplasty Register (NAR) for cemented TKA without patella component from 1994–2009. A questionnaire regarding surgeon volume in 2000 and 2009 was sent to all 58 operating hospitals in Norway, as this is not registered in the NAR. We received responses from 29 hospitals. Surgeon volume was defined by the percentage of surgeons at the hospital who operated 1–10 TKA over a year. Cox regression (without adjustment) was used to estimate proportions without revision and relative differences (RR). Analyses were also done for a subset of commonly used prostheses (AGC, LCS, LCS Complete, Duracon,