• Bryce A Basques, Adam Bitterman, Kevin J Campbell, Bryan D Haughom, Johnny Lin, and Simon Lee.
• Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
• Foot Ankle Int. 2016 Oct 1; 37 (10): 1046-1051.

BackgroundIncreased surgeon volume may be associated with improved outcomes following operative procedures. However, there is a lack of information on the effect of surgeon volume on inpatient adverse events and resource utilization following total ankle arthroplasty (TAA).MethodsA retrospective cohort study of TAA patients was performed using the Nationwide Inpatient Sample (NIS) from 2003 to 2009. High-volume surgeons were considered as those with volume ≥90th percentile of surgeons performing TAA. Multivariate regression was used to compare the rates of adverse events, hospital length of stay, and total hospital charges between surgeon volume categories.ResultsA total of 4800 TAA patients were identified. The 90th percentile for surgeon volume was 21 cases per year. Mean length of stay was 2.8 ± 2.3 days and mean hospital charges were $45 963 ± $43 983. On multivariate analysis, high-volume surgeons had decreased overall complications (OR 0.5, P = .034) and rate of medial malleolus fracture (OR 0.1, P = .043), decreased length of stay (-0.9 days, P < .001), and decreased hospital charges (-$20 904, P < .001).ConclusionsSurgeons with volume ≥90th percentile had a decreased rate of complications, decreased length of stay, and reduced hospital charges compared to other surgeons.Level Of EvidenceLevel III, comparative study.© The Author(s) 2016.

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