title: Association of surgeon factors with outcome scores after total knee arthroplasty.
abstract: OBJECTIVE
  To identify preoperative factors (including surgeon factors) associated with outcome scores after total knee arthroplasty (TKA).
  
  
  METHODS
  Medical records of 2848 patients (3458 knees) who underwent primary TKA by 27 orthopaedic specialists were retrieved. Three specialty knee surgeons who had one-year fellowship in TKA performed 1930 TKAs, and 24 general orthopaedic surgeons performed 1528 TKAs. Four of them (including all 3 specialty knee surgeons) were ultrahigh- volume (≥ 100 TKAs a year), and 21 of them were senior consultants (≥ 5 years post residency). At 2 years, 2922 (85%) of knees had complete followup data. Oxford Knee Score, Knee Society knee and function scores, and SF-36 quality-of-life score were assessed by independent physiotherapists before and after surgery. Outcomes were compared in terms of dichotomised specialty, seniority, and surgical volume of surgeons.
  
  
  RESULTS
  Comparing ultra-high-volume (≥ 100 TKAs per year) specialty knee surgeons with general orthopaedic surgeons, the former achieved better outcomes in terms of the Oxford Knee Score at 6 months, Knee Society knee and function scores at 2 years, and SF-36 scores at 6 months and 2 years. Comparing lower-volume (<100 TKAs per year) specialty knee surgeons with general orthopaedic surgeons, the former still achieved better outcome and quality-of-life scores, except for SF-36 Mental Component Score at 2 years.
  
  
  CONCLUSIONS
  Specialty training and clinical research in TKA improved outcome and quality-of-life scores.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors.forename: Sok-Chuen
authors.initials: SC
authors.lastname: Tan
authors.forename: Yiong-Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Hwei-Chi
authors.initials: HC
authors.lastname: Chong
authors.forename: Pak-Lin
authors.initials: PL
authors.lastname: Chin
authors.forename: Andy
authors.initials: A
authors.lastname: Yew
authors.forename: Shi-Lu
authors.initials: SL
authors.lastname: Chia
authors.forename: Darren
authors.initials: D
authors.lastname: Tay
authors.forename: Ngai-Nung
authors.initials: NN
authors.lastname: Lo
authors.forename: Seng-Jin
authors.initials: SJ
authors.lastname: Yeo
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D002983:Clinical Competence; D005257:Fellowships and Scholarships / Q000706:statistics & numerical data; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000706:statistics & numerical data*; D020370:Osteoarthritis, Knee / Q000601:surgery*; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D016896:Treatment Outcome
keywords: arthroplasty, replacement, knee; hospitals, high-volume