{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:13:37Z","timestamp":1787022817486,"version":"build-2736575974"},"reference-count":28,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["eor.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:p>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>\n                          <jats:italic>Purpose:<\/jats:italic>\n                          Total elbow arthroplasty (TEA) is rarely performed compared to other arthroplasties. For many surgical procedures, literature shows better outcomes when they are performed by experienced surgeons and in so-called \u2018high-volume\u2019 hospitals. We systematically reviewed the literature on the relationship between surgical volume and outcomes following TEA.\n                        <\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\n                          <jats:italic>Methods:<\/jats:italic>\n                          A literature search was performed using the MEDLINE, EMBASE and CINAHL databases. The literature was systematically reviewed for original studies comparing TEA outcomes among hospitals or surgeons with different annual or career volumes. For each study, data were collected on study design, indications for TEA, number of included patients, implant types, cut-off values for volume, number and types of complications, revision rate and functional outcome measures. The methodological quality of the included studies was assessed using the Newcastle\u2013Ottawa Scale.\n                        <\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\n                          <jats:italic>Results:<\/jats:italic>\n                          Two studies, which included a combined 2301 TEAs, found that higher surgeon volumes were associated with lower revision rates. The examined complication rates did not differ between high- and low-volume surgeons. In one study, low-hospital volume is associated with an increased risk of revision compared to high-volume hospitals, but for other complication types, no difference was found.\n                        <\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\n                          <jats:italic>Conclusions:<\/jats:italic>\n                          Based on the results, the evidence suggests that high-volume centers have a lower revision rate in the long term. No minimum amount of procedures per year can be advised, as the included studies have different cut-off values between groups. As higher surgeon- and center-volume, (therefore presumably experience) appear to yield better outcomes, centralization of total elbow arthroplasty should be encouraged.\n                        <\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>","DOI":"10.1530\/eor-22-0087","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T10:10:38Z","timestamp":1674814238000},"page":"45-51","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":13,"title":["Is there a relationship between surgical volume and outcome for total elbow arthroplasty? A systematic review"],"prefix":"10.1530","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2920-8564","authenticated-orcid":true,"given":"A","family":"Prki\u0107","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Upper Limb Section, Amphia Hospital, Breda, The Netherlands"},{"name":"Amsterdam UMC Location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N P","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Upper Limb Section, Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B W","family":"Kooistra","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Upper Limb Section, Amphia Hospital, Breda, The Netherlands"},{"name":"Department of Orthopedic Surgery, Shoulder and Elbow Unit, OLVG, Amsterdam, The Netherlands"},{"name":"Department of Orthopedic Surgery, Medische Kliniek Velsen, Velsen-Noord, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"The","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Upper Limb Section, Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M P J","family":"van den Bekerom","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Medische Kliniek Velsen, Velsen-Noord, The Netherlands"},{"name":"Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Eygendaal","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, ErasmusMC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Dutch Arthroplasty Register. Dutch Arthroplasty Register","unstructured":"Dutch Arthroplasty Register. Dutch Arthroplasty Register [Internet]. Available at: http:\/\/www.lroi-rapportage.nl\/"},{"key":"bib2","series-title":"World Journal of Orthopedics","article-title":"Total elbow arthroplasty is moving forward: review on past, present and future","volume":"7","author":"Prkic","year":"2016","unstructured":"Prkic Avan Bergen CJAThe BEygendaal D. Total elbow arthroplasty is moving forward: review on past, present and future. World Journal of Orthopedics20167 44\u201349. (https:\/\/doi.org\/10.5312\/wjo.v7.i1.44)"},{"key":"bib3","series-title":"Journal of Shoulder and Elbow Surgery","first-page":"339","article-title":"Total elbow arthroplasty: outcomes after triceps-detaching and triceps-sparing approaches","volume":"24","author":"Dachs","year":"2015","unstructured":"Dachs RPFleming MAChivers DACarrara HRDu Plessis JPVrettos BCRoche SJ. Total elbow arthroplasty: outcomes after triceps-detaching and triceps-sparing approaches. Journal of Shoulder and Elbow Surgery201524339\u2013347. (https:\/\/doi.org\/10.1016\/j.jse.2014.11.038)"},{"key":"bib4","series-title":"Journal of Shoulder and Elbow Surgery","first-page":"381","article-title":"Outcomes after revision total elbow arthroplasty: a systematic review","volume":"28","author":"Geurts","year":"2019","unstructured":"Geurts EJViveen Jvan Riet RPKodde IFEygendaal D. Outcomes after revision total elbow arthroplasty: a systematic review. Journal of Shoulder and Elbow Surgery201928381\u2013386. (https:\/\/doi.org\/10.1016\/j.jse.2018.08.024)"},{"key":"bib5","series-title":"Journal of Arthroplasty","first-page":"1","article-title":"Improving value in total hip and knee arthroplasty: the role of high volume hospitals","volume":"33","author":"Courtney","year":"2018","unstructured":"Courtney PMFrisch NBBohl DDDella Valle CJ. Improving value in total hip and knee arthroplasty: the role of high volume hospitals. Journal of Arthroplasty2018331\u20135. (https:\/\/doi.org\/10.1016\/j.arth.2017.07.040)"},{"key":"bib6","series-title":"Archives of Orthopaedic and Trauma Surgery","first-page":"761","article-title":"Why does total elbow arthroplasty fail today? A systematic review of recent literature","volume":"137","author":"Prkic","year":"2017","unstructured":"Prkic AWelsink CThe Bvan den Bekerom MPJEygendaal D. Why does total elbow arthroplasty fail today? A systematic review of recent literature. Archives of Orthopaedic and Trauma Surgery2017137761\u2013769. (https:\/\/doi.org\/10.1007\/s00402-017-2687-x)"},{"key":"bib7","series-title":"Journal of Bone and Joint Surgery. British Volume","first-page":"437","article-title":"Total elbow arthroplasty: a systematic review of the literature in the English language until the end of 2003","volume":"87","author":"Little","year":"2005","unstructured":"Little CPGraham AJCarr AJ. Total elbow arthroplasty: a systematic review of the literature in the English language until the end of 2003. Journal of Bone and Joint Surgery. British Volume200587437\u2013444. (https:\/\/doi.org\/10.1302\/0301-620X.87B4.15692)"},{"key":"bib8","series-title":"Clinical Orthopaedics and Related Research","first-page":"35","article-title":"Orthopaedic procedure volume and patient outcomes: a systematic literature review","volume":"457","author":"Shervin","year":"2007","unstructured":"Shervin NRubash HEKatz JN. Orthopaedic procedure volume and patient outcomes: a systematic literature review. Clinical Orthopaedics and Related Research200745735\u201341. (https:\/\/doi.org\/10.1097\/BLO.0b013e3180375514)"},{"key":"bib9","series-title":"Journal of Bone and Joint Surgery. American Volume","first-page":"702","article-title":"Center and surgeon volume influence the revision rate following unicondylar knee replacement an analysis of 23,400 medial cemented unicondylar knee replacements","volume":"95","author":"Baker","year":"2013","unstructured":"Baker PJameson SCritchley RReed MGregg PDeehan D. Center and surgeon volume influence the revision rate following unicondylar knee replacement an analysis of 23,400 medial cemented unicondylar knee replacements. Journal of Bone and Joint Surgery. American Volume201395702\u2013709. (https:\/\/doi.org\/10.2106\/JBJS.L.00520)"},{"key":"bib10","series-title":"Journal of Orthopaedic Surgery and Research","first-page":"468","article-title":"Effect of hospital volume on outcomes of total hip arthroplasty: a systematic review and meta-analysis","volume":"14","author":"Mufarrih","year":"2019","unstructured":"Mufarrih SHGhani MOAMartins RSQureshi NQMufarrih SAMalik ATNoordin S. Effect of hospital volume on outcomes of total hip arthroplasty: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research201914468. (https:\/\/doi.org\/10.1186\/s13018-019-1531-0)"},{"key":"bib11","series-title":"ANZ Journal of Surgery","first-page":"234","article-title":"Centralization and the relationship between volume and outcome in knee arthroplasty procedures","volume":"80","author":"Marlow","year":"2010","unstructured":"Marlow NEBarraclough BCollier NADickinson ICFawcett JGraham JCMaddern GJ. Centralization and the relationship between volume and outcome in knee arthroplasty procedures. ANZ Journal of Surgery201080234\u2013241. (https:\/\/doi.org\/10.1111\/j.1445-2197.2010.05243.x)"},{"key":"bib12","series-title":"Knee","first-page":"513","article-title":"Does surgical volume affect outcome after primary and revision knee arthroplasty? A systematic review of the literature","volume":"19","author":"Critchley","year":"2012","unstructured":"Critchley RJBaker PNDeehan DJ. Does surgical volume affect outcome after primary and revision knee arthroplasty? A systematic review of the literature. Knee201219513\u2013518. (https:\/\/doi.org\/10.1016\/j.knee.2011.11.007)"},{"key":"bib13","series-title":"Acta Orthopaedica","first-page":"119","article-title":"Total elbow replacement: outcome of 1,146 arthroplasties from the Scottish Arthroplasty Project","volume":"84","author":"Jenkins","year":"2013","unstructured":"Jenkins PJWatts ACNorwood TDuckworth ADRymaszewski LAMceachan JE. Total elbow replacement: outcome of 1,146 arthroplasties from the Scottish Arthroplasty Project. Acta Orthopaedica201384119\u2013123. (https:\/\/doi.org\/10.3109\/17453674.2013.784658)"},{"key":"bib14","series-title":"Open Orthopaedics Journal","first-page":"115","article-title":"Total elbow arthroplasty","volume":"5","author":"Sanchez-Sotelo","year":"2011","unstructured":"Sanchez-Sotelo JTotal elbow arthroplasty. Open Orthopaedics Journal20115115\u2013123. (https:\/\/doi.org\/10.2174\/1874325001105010115)"},{"key":"bib15","series-title":"Journal of Clinical Epidemiology","first-page":"982","article-title":"Testing the Newcastle Ottawa Scale showed low reliability between individual reviewers","volume":"66","author":"Hartling","year":"2013","unstructured":"Hartling LMilne AHamm MPVandermeer BAnsari MTsertsvadze ADryden DM. Testing the Newcastle Ottawa Scale showed low reliability between individual reviewers. Journal of Clinical Epidemiology201366982\u2013993. (https:\/\/doi.org\/10.1016\/j.jclinepi.2013.03.003)"},{"key":"bib16","series-title":"BMJ Group","first-page":"e001368","article-title":"Inter-rater and test-retest reliability of quality assessments by Novice Student Raters using the Jadad and Newcastle-Ottawa Scales","volume":"2","author":"Oremus","year":"2012","unstructured":"Oremus MOremus CHall GBCMcKinnon MCGraham AGregory CInter-rater and test-retest reliability of quality assessments by Novice Student Raters using the Jadad and Newcastle-Ottawa Scales. BMJ Group20122e001368. (https:\/\/doi.org\/10.1136\/bmjopen-2012-001368)"},{"key":"bib17","series-title":"Journal of Bone and Joint Surgery. American Volume","first-page":"110","article-title":"Indications and reoperation rates for total elbow arthroplasty: an analysis of trends in New York State","volume":"94","author":"Gay","year":"2012","unstructured":"Gay DMLyman SDo HHotchkiss RNMarx RGDaluiski A. Indications and reoperation rates for total elbow arthroplasty: an analysis of trends in New York State. Journal of Bone and Joint Surgery. American Volume201294110\u2013117. (https:\/\/doi.org\/10.2106\/JBJS.J.01128)"},{"key":"bib18","series-title":"Journal of Hand Surgery","first-page":"68","article-title":"Complication and revision rates following total elbow arthroplasty","volume":"36","author":"Krenek","year":"2011","unstructured":"Krenek LFarng EZingmond DSoohoo NF. Complication and revision rates following total elbow arthroplasty. Journal of Hand Surgery20113668\u201373. (https:\/\/doi.org\/10.1016\/j.jhsa.2010.09.036)"},{"key":"bib19","series-title":"Acta Orthopaedica","first-page":"472","article-title":"Total elbow arthroplasty in rheumatoid arthritis: a population-based study from the Finnish Arthroplasty Register","volume":"80","author":"Skytt\u00e4","year":"2009","unstructured":"Skytt\u00e4 ETEskelinen APaavolainen PIk\u00e4valko MRemes V. Total elbow arthroplasty in rheumatoid arthritis: a population-based study from the Finnish Arthroplasty Register. Acta Orthopaedica200980472\u2013477. (https:\/\/doi.org\/10.3109\/17453670903110642)"},{"key":"bib20","series-title":"Journal of Shoulder and Elbow Surgery","first-page":"367","article-title":"Assessing the hospital volume\u2013outcome relationship in total elbow arthroplasty","volume":"31","author":"Poff","year":"2022","unstructured":"Poff CKunkle BLi XFriedman RJEichinger JK. Assessing the hospital volume\u2013outcome relationship in total elbow arthroplasty. Journal of Shoulder and Elbow Surgery202231367\u2013374. (https:\/\/doi.org\/10.1016\/j.jse.2021.08.025)"},{"key":"bib21","series-title":"New England Journal of Medicine","first-page":"1364","article-title":"Should operations be regionalized? The empirical relation between surgical volume and mortality","volume":"301","author":"Luft","year":"1979","unstructured":"Luft HSBunker JPEnthoven AC. Should operations be regionalized? The empirical relation between surgical volume and mortality. New England Journal of Medicine19793011364\u20131369. (https:\/\/doi.org\/10.1056\/NEJM197912203012503)"},{"key":"bib22","series-title":"CMAJ","first-page":"1409","article-title":"Differences in operative mortality between high- and low-volume hospitals in Ontario for 5 major surgical procedures: estimating the number of lives potentially saved through regionalization","volume":"168","author":"Urbach","year":"2003","unstructured":"Urbach DRBell CMAustin PC. Differences in operative mortality between high- and low-volume hospitals in Ontario for 5 major surgical procedures: estimating the number of lives potentially saved through regionalization. CMAJ20031681409\u20131414."},{"key":"bib23","series-title":"PLoS One","first-page":"e0244078","article-title":"Regionalization for health improvement: A systematic review","volume":"15","author":"Ramos","year":"2020","unstructured":"Ramos MCBarreto JOMShimizu HEMoraes APGSilva END. Regionalization for health improvement: A systematic review. PLoS One202015e0244078. (https:\/\/doi.org\/10.1371\/journal.pone.0244078)"},{"key":"bib24","series-title":"Annals of Surgery","first-page":"339","article-title":"Regional trauma system reduces mortality and changes admission rates: A before and after study","volume":"251","author":"Twijnstra","year":"2010","unstructured":"Twijnstra MJMoons KGMSimmermacher RKJLeenen LPH. Regional trauma system reduces mortality and changes admission rates: A before and after study. Annals of Surgery2010251339\u2013343. (https:\/\/doi.org\/10.1097\/SLA.0b013e3181c0e910)"},{"key":"bib25","series-title":"Journal of Arthroplasty","first-page":"S76","article-title":"Increased orthopedic specialization lowers costs and improves outcomes in total joint arthroplasty","volume":"34","author":"Bockhorn","year":"2019","unstructured":"Bockhorn LNGoytia RNLaughlin MSPatel AR. Increased orthopedic specialization lowers costs and improves outcomes in total joint arthroplasty. Journal of Arthroplasty201934S76\u2013S79. (https:\/\/doi.org\/10.1016\/j.arth.2019.02.019)"},{"key":"bib26","series-title":"EFORT Open Reviews","first-page":"215","article-title":"Global trends in indications for total elbow arthroplasty: a systematic review of national registries","volume":"5","author":"Macken","year":"2020","unstructured":"Macken AAPrkic AKodde IFLans JChen NCEygendaal D. Global trends in indications for total elbow arthroplasty: a systematic review of national registries. EFORT Open Reviews20205215\u2013220. (https:\/\/doi.org\/10.1302\/2058-5241.5.190036)"},{"key":"bib27","series-title":"Journal of Shoulder and Elbow Surgery","first-page":"3","article-title":"A multicenter, prospective, randomized, controlled trial of open reduction-internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients","volume":"18","author":"McKee","year":"2009","unstructured":"McKee MDVeillette CJHHall JASchemitsch EHWild LMMcCormack RPerey BGoetz TZomar MMoon KA multicenter, prospective, randomized, controlled trial of open reduction-internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients. Journal of Shoulder and Elbow Surgery2009183\u201312. (https:\/\/doi.org\/10.1016\/j.jse.2008.06.005)"},{"key":"bib28","series-title":"Shoulder and Elbow","first-page":"292","article-title":"Total elbow arthroplasty survey 2015: current service provision and future improvements (England and Wales)","volume":"11","author":"Abdelmalek","year":"2019","unstructured":"Abdelmalek ADonaldson O. Total elbow arthroplasty survey 2015: current service provision and future improvements (England and Wales). Shoulder and Elbow201911292\u2013299. (https:\/\/doi.org\/10.1177\/1758573218763126)"}],"container-title":["EFORT Open Reviews"],"original-title":[],"link":[{"URL":"https:\/\/eor.bioscientifica.com\/view\/journals\/eor\/8\/1\/EOR-22-0087.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eor.bioscientifica.com\/downloadpdf\/journals\/eor\/8\/1\/EOR-22-0087.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/eor.bioscientifica.com\/downloadpdf\/journals\/eor\/8\/1\/EOR-22-0087.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:50:51Z","timestamp":1784555451000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/eor\/article\/8\/1\/45-51\/2499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,1]]},"references-count":28,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.1530\/eor-22-0087","relation":{},"ISSN":["2058-5241"],"issn-type":[{"value":"2058-5241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,1]]}}}