Bibliometric Analysis of Outpatient Hip and Knee Arthroplasty Research Evolution

Document Type : RESEARCH PAPER

Authors

1 Faculty of Medicine, Saint Joseph University, Beirut, Lebanon

2 Department of Orthopaedic Surgery and Sports Medicine, Detroit Medical Center, Detroit, MI, USA

3 School of Medicine, Wayne State University, Detroit, Michigan, USA

4 PeriOpti, Ann Arbor, MI, USA

5 Department of Orthopaedic Surgery, Brown University, Providence, RI, USA

10.22038/abjs.2024.80590.3681

Abstract

Objectives: Total joint arthroplasty is an effective treatment for end stage osteoarthritis. As 
perioperative protocols are developed, outpatient arthroplasty has been gaining traction to facilitate 
earlier recovery and same day discharge. The aim of this manuscript is to analyze the trends i n 
outpatient arthroplasty over a 17-year duration. This analysis seeks to predict emerging themes in the 
literature on patient optimization and outcomes in outpatient arthroplasty.
Methods: This study conducted a literature review on outpatient arthroplasty with the Web of Science Core 
Collection over a 17-year period between 2005 and 2022. Bibliometric data was imported and analyzed with 
Bibliometrix and VOSviewer.
Results: 198 articles were identified demonstrating an annual growth of 19.61% with notable bursts in 2017 and 
2021. United States was the top global contributor followed by Canada and European nations. There were significant 
contributions across 219 institutions and 758 authors, with the Journal of Arthroplasty being the most productive 
and influential journals. Key themes identified include the feasibility of outpatient surgery, pain management, and 
perioperative complications and costs.
Conclusion: This bibliometric analysis highlights the ongoing growth and development within outpatient arthroplasty 
since 2005. The United States remain the global leader within outpatient related arthroplasty research. Previous, 
current, and ongoing trends are highlighted within this field for further development as hotspots.
 Level of evidence: III

Keywords

Main Subjects

References

  1. Wylde V, Dieppe P, Hewlett S, Learmonth ID. Total knee replacement: is it really an effective procedure for all? Knee. 2007; 14(6):417-423. doi:10.1016/j.knee.2007.06.001.
  2. Gojło MK, Lundqvist R, Paradowski PT. Short-term patient-reported outcomes following total hip replacement: Is the success picture overrated? Osteoarthr Cartil Open. 2021; 3(3):100192. doi:10.1016/j.ocarto.2021.100192.
  3. Daher M, Estephan M, Ghoul A, Tarchichi J, Mansour J. Hip Strengthening After Total Knee Arthroplasty: A Meta-analysis and Systematic Review. Arch Bone Jt Surg. 2024; 12(6):373. doi:10.22038/ABJS.2024.76202.3520.
  4. Jüni P, Reichenbach S, Dieppe P. Osteoarthritis: rational approach to treating the individual. Best Pract Res Clin Rheumatol. 2006; 20(4):721-740. doi:10.1016/j.berh.2006.05.002.
  5. Daher M, Haykal G, Ghoul A, Tarchichi J, Sebaaly A. The Efficacy of Bone Wax in Total Joint Arthroplasty: A Systematic Review and Meta-Analysis. Arch Bone Jt Surg. 2024; 12(5):298. doi:10.22038/ABJS.2024.73243.3392.
  6. Shichman I, Roof M, Askew N, et al. Projections and Epidemiology of Primary Hip and Knee Arthroplasty in Medicare Patients to 2040-2060. JB JS Open Access. 2023; 8(1):e22.00112. doi:10.2106/JBJS.OA.22.00112.
  7. Woolf SH, Schoomaker H. Life expectancy and mortality rates in the United States, 1959-2017. Jama. 2019; 322(20):1996-2016. doi:10.1001/jama.2019.16932.
  8. Sloan M, Premkumar A, Sheth NP. Projected Volume of Primary Total Joint Arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am. 2018; 100(17):1455-1460. doi:10.2106/JBJS.17.01617.
  9. Rodríguez-Merchán EC. Outpatient total knee arthroplasty: is it worth considering? EFORT Open Rev. 2020; 5(3):172-179. doi:10.1302/2058-5241.5.180101.
  10. Hao T, Chen X, Li G, Yan J. A bibliometric analysis of text mining in medical research. Soft Comput. 2018; 22(23):7875-7892. doi:10.1007/s00500-018-3511-4.
  11. Lovald ST, Ong KL, Malkani AL, et al. Complications, mortality, and costs for outpatient and short-stay total knee arthroplasty patients in comparison to standard-stay patients. J Arthroplasty. 2014; 29(3):510-515. doi:10.1016/j.arth.2013.07.020.
  12. Berger RA, Sanders SA, Thill ES, Sporer SM, Della Valle C. Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop. 2009; 467(6):1424-1430. doi:10.1007/s11999-009-0741-x.
  13. Berger RA, Kusuma SK, Sanders SA, Thill ES, Sporer SM. The feasibility and perioperative complications of outpatient knee arthroplasty. Clin Orthop. 2009; 467(6):1443-1449. doi:10.1007/s11999-009-0736-7.
  14. Zhang H, Fan Y, Wang R, et al. Research trends and hotspots of high tibial osteotomy in two decades (from 2001 to 2020): a bibliometric analysis. J Orthop Surg. 2020; 15(1):512. doi:10.1186/s13018-020-01991-1.
  15. Berger RA, Sanders SA, Thill ES, Sporer SM, Della Valle C. Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop. 2009; 467(6):1424-1430. doi:10.1007/s11999-009-0741-x.
  16. Fabrés Martín C, Ventura Parellada C, Herrero Antón de Vez H, Ordoñez Urgiles CE, Alonso-Rodríguez Piedra J, Mora Guix JM. Telemedicine approach for patient follow-up after total knee and reverse total shoulder arthroplasty: a pilot study. Int J Comput Assist Radiol Surg. 2023; 18(3):595-602. doi:10.1007/s11548-022-02784-z.
  17. Goeb YL, Krell EC, Nguyen JT, et al. Early Recovery Outcomes in Patients Undergoing Total Hip Arthroplasty through a Posterior Approach with Modified Postoperative Precautions. J Arthroplasty. 2021; 36(8):2817-2822. doi:10.1016/j.arth.2021.03.038.
  18. Muertizha M, Cai X, Ji B, Aimaiti A, Cao L. Factors contributing to 1-year dissatisfaction after total knee arthroplasty: a nomogram prediction model. J Orthop Surg. 2022; 17(1):367. doi:10.1186/s13018-022-03205-2.
  19. Marsh J, Joshi I, Somerville L, Vasarhelyi E, Lanting B. Health care costs after total knee arthroplasty for satisfied and dissatisfied patients. Can J Surg .2022; 65(5):E562-E566. doi:10.1503/cjs.006721.
  20. Richards JD, Stoddart M, Bolland B, Richards JD, Stoddart M, Bolland B. Virtual Arthroplasty Follow-Up: Better for the Trust, Patients, and the Planet. Cureus. 2022; 14(11). doi:10.7759/cureus.31978.
  21. Yang C, Shang L, Yao S, Ma J, Xu C. Cost, time savings and effectiveness of wearable devices for remote monitoring of patient rehabilitation after total knee arthroplasty: study protocol for a randomized controlled trial. J Orthop Surg. 2023; 18(1):461. doi:10.1186/s13018-023-03898-z.
  22. Nielsen NI, Kehlet H, Gromov K, et al. High dose dexamethasone in high pain responders undergoing total hip arthroplasty: A randomized controlled trial. Eur J Anaesthesiol. 2023; 40(10):737-746. doi:10.1097/EJA.0000000000001853.
  23. Vitola E, Buraka N, Erts R, Golubovska I, Miscuks A. Effect of different low doses of intrathecal morphine (0.1 and 0.2 mg) on pain and vital functions in patients undergoing total hip arthroplasty: a randomised controlled study. BMC Anesthesiol. 2022; 22(1):377. doi:10.1186/s12871-022-01919-8.
  24. Wainwright TW. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery after Surgery (ERAS®) Society recommendations. Acta Orthop. 2020; 91(3):363. doi:10.1080/17453674.2020.1724674.
  25. Stuhlreyer J, Roder C, Krug F, Zöllner C, Flor H, Klinger R. A digital application and augmented physician rounds reduce postoperative pain and opioid consumption after primary total knee replacement (TKR): a randomized clinical trial. BMC Med. 2022; 20(1):469. doi:10.1186/s12916-022-02638-0.
  26. Barello S, Triberti S, Graffigna G, et al. eHealth for Patient Engagement: A Systematic Review. Front Psychol. 2015; 6:2013. doi:10.3389/fpsyg.2015.02013.
  27. Zhang Q, Chen Y, Li Y, et al. Enhanced recovery after surgery in patients after hip and knee arthroplasty: a systematic review and meta-analysis. Postgrad Med J. 2024; 100(1181):159-173. doi:10.1093/postmj/qgad125.
  28. Morrell AT, Layon DR, Scott MJ, Kates SL, Golladay GJ, Patel NK. Enhanced Recovery After Primary Total Hip and Knee Arthroplasty: A Systematic Review. J Bone Joint Surg Am. 2021; 103(20):1938-1947. doi:10.2106/JBJS.20.02169.
  29. Lyman S, Jones EC, Bach PB, Peterson MGE, Marx RG. The association between hospital volume and total shoulder arthroplasty outcomes. Clin Orthop. 2005 ;(432):132-137. doi:10.1097/01.blo.0000150571.51381.9a.
  30. Dunn JC, Lanzi J, Kusnezov N, Bader J, Waterman BR, Belmont PJ. Predictors of length of stay after elective total shoulder arthroplasty in the United States. J Shoulder Elbow Surg. 2015; 24(5):754-759. doi:10.1016/j.jse.2014.11.042.
  31. Parcells BW, Giacobbe D, Macknet D, et al. Total Joint Arthroplasty in a Stand-alone Ambulatory Surgical Center: Short-term Outcomes. Orthopedics. 2016; 39(4):223-228. doi:10.3928/01477447-20160419-06.
  32. Sher A, Keswani A, Yao DH, Anderson M, Koenig K, Moucha CS. Predictors of Same-Day Discharge in Primary Total Joint Arthroplasty Patients and Risk Factors for Post-Discharge Complications. J Arthroplasty. 2017; 32(9S):S150-S156.e1. doi:10.1016/j.arth.2016.12.017.
  33. Crawford DC, Li CS, Sprague S, Bhandari M. Clinical and Cost Implications of Inpatient versus Outpatient Orthopedic Surgeries: A Systematic Review of the Published Literature. Orthop Rev. 2015; 7(4):6177. doi:10.4081/or.2015.6177.
  34. Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2 Suppl):e419S-e496S. doi:10.1378/chest.11-2301.
  35. Mont MA, Jacobs JJ. AAOS clinical practice guideline: preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty. J Am Acad Orthop Surg. 2011; 19(12):777-778. doi:10.5435/00124635-201112000-00008.
  36. Runner RP, Gottschalk MB, Staley CA, Pour AE, Roberson JR. Utilization Patterns, Efficacy, and Complications of Venous Thromboembolism Prophylaxis Strategies in Primary Hip and Knee Arthroplasty as Reported by American Board of Orthopedic Surgery Part II Candidates. J Arthroplasty. 2019; 34(4):729-734. doi:10.1016/j.arth.2018.12.015.
  37. Mirkazemi C, Bereznicki LR, Peterson GM. Comparing Australian orthopaedic surgeons’ reported use of thromboprophylaxis following arthroplasty in 2012 and 2017. BMC Musculoskelet Disord. 2019; 20(1):57. doi:10.1186/s12891-019-2409-3.
  38. Kim S, Ahn H, Shin SA, Park JH, Won CW. Trends of thromboprophylaxis and complications after major lower limb orthopaedic surgeries in Korea: National Health Insurance Claim Data. Thromb Res. 2017; 155:48-52. doi:10.1016/j.thromres.2017.04.023.
  39. Kim NK, Kim TK, Kim JM, Chun CH. Prophylaxis for Venous Thromboembolism Following Total Knee Arthroplasty: A Survey of Korean Knee Surgeons. Knee Surg Relat Res. 2016; 28(3):207-212. doi:10.5792/ksrr.2016.28.3.207.
  40. Yhim HY, Lee J, Lee JY, Lee JO, Bang SM. Pharmacological thromboprophylaxis and its impact on venous thromboembolism following total knee and hip arthroplasty in Korea: A nationwide population-based study. PLoS ONE. 2017; 12(5):e0178214. doi:10.1371/journal.pone.0178214.
  41. Matharu GS, Kunutsor SK, Judge A, Blom AW, Whitehouse MR. Clinical Effectiveness and Safety of Aspirin for Venous Thromboembolism Prophylaxis after Total Hip and Knee Replacement: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Intern Med. 2020; 180(3):376-384. doi:10.1001/jamainternmed.2019.6108.
  42. Rondon AJ, Shohat N, Tan TL, Goswami K, Huang RC, Parvizi J. The Use of Aspirin for Prophylaxis against Venous Thromboembolism Decreases Mortality Following Primary Total Joint Arthroplasty. J Bone Joint Surg Am. 2019; 101(6):504-513. doi:10.2106/JBJS.18.00143.
  43. Faour M, Piuzzi NS, Brigati DP, et al. Low-Dose Aspirin Is Safe and Effective for Venous Thromboembolism Prophylaxis Following Total Knee Arthroplasty. J Arthroplasty. 2018; 33(7S):S131-S135. doi:10.1016/j.arth.2018.03.001.
  44. Faour M, Piuzzi NS, Brigati DP, et al. No Difference between Low- and Regular-dose Aspirin for Venous Thromboembolism Prophylaxis after THA. Clin Orthop. 2019; 477(2):396-402. doi:10.1097/CORR.0000000000000613.
  45. Tan TL, Shohat N, Rondon AJ, et al. Perioperative Antibiotic Prophylaxis in Total Joint Arthroplasty: A Single Dose Is as Effective as Multiple Doses. J Bone Joint Surg Am. 2019; 101(5):429-437. doi:10.2106/JBJS.18.00336.
  46. Wyles CC, Vargas-Hernandez JS, Carlson SW, Carlson BC, Sierra RJ. Single-Dose Perioperative Antibiotics Do Not Increase the Risk of Surgical Site Infection in Unicompartmental Knee Arthroplasty. J Arthroplasty. 2019; 34(7S):S327-S330. doi:10.1016/j.arth.2019.02.041.
  47. Yendluri A, Park J, Singh P, et al. Oral Postoperative Antibiotic Prophylaxis for Outpatient Total Hip and Knee Arthroplasty: Describing Current Practices. J Arthroplasty. 2024; 39(8):1911-1916.e1. doi:10.1016/j.arth.2024.04.024.
  48. Spangehl M. Preoperative Prophylactic Antibiotics in Total Hip and Knee Arthroplasty: What, When, and How. J Arthroplasty. 2022; 37(8):1432-1434. doi:10.1016/j.arth.2022.01.019.
  49. Karczewski D, Winkler T, Renz N, et al. A standardized interdisciplinary algorithm for the treatment of prosthetic joint infections. Bone Jt J. 2019; 101-B (2):132-139. doi:10.1302/0301-620X.101B2.BJJ-2018-1056.R1.
  50. Clemente A, Cavagnaro L, Russo A, Chiarlone F, Massè A, Burastero G. Spacer exchange in persistent periprosthetic joint infection: microbiological evaluation and survivorship analysis. Arch Orthop Trauma Surg. 2023; 143(3):1361-1370. doi:10.1007/s00402-021-04300-5.
  51. Bedair HS, Katakam A, Bedeir YH, Yeroushalmi D, Schwarzkopf R. A decision analysis of treatment strategies for acute periprosthetic joint infection: Early irrigation and debridement versus delayed treatment based on organism. J Orthop. 2020;22:246-250. doi:10.1016/j.jor.2020.04.003.

 

  1. Davis JS, Metcalf S, Clark B, et al. Predictors of Treatment Success after Periprosthetic Joint Infection: 24-Month Follow up From a Multicenter Prospective Observational Cohort Study of 653 Patients. Open Forum Infect Dis. 2022; 9(3):ofac048. doi:10.1093/ofid/ofac048.
  2. Geary MB, Macknet DM, Ransone MP, Odum SD, Springer BD. Why Do Revision Total Knee Arthroplasties Fail? A Single-Center Review of 1632 Revision Total Knees Comparing Historic and Modern Cohorts. J Arthroplasty. 2020; 35(10):2938-2943. doi:10.1016/j.arth.2020.05.050.
  3. Wildeman P, Rolfson O, Söderquist B, Wretenberg P, Lindgren V. What Are the Long-term Outcomes of Mortality, Quality of Life, and Hip Function after Prosthetic Joint Infection of the Hip? A 10-year Follow-up from Sweden. Clin Orthop. 2021; 479(10):2203-2213. doi:10.1097/CORR.0000000000001838.
  4. Foran JRH, Mont MA, Etienne G, Jones LC, Hungerford DS. The outcome of total knee arthroplasty in obese patients. J Bone Joint Surg Am. 2004; 86(8):1609-1615. doi:10.2106/00004623-200408000-00002.
  5. Namba RS, Paxton L, Fithian DC, Stone ML. Obesity and perioperative morbidity in total hip and total knee arthroplasty patients. J Arthroplasty. 2005; 20(7 Suppl 3):46-50. doi:10.1016/j.arth.2005.04.023.
  6. Sambandam S, Serbin P, Senthil T, et al. Patient Characteristics, Length of Stay, Cost of Care, and Complications in Super-Obese Patients Undergoing Total Hip Arthroplasty: A National Database Study. Clin Orthop Surg. 2023; 15(3):380-387. doi:10.4055/cios22180.
  7. Wall CJ, Vertullo CJ, Kondalsamy-Chennakesavan S, Lorimer MF, de Steiger RN. A Prospective, Longitudinal Study of the Influence of Obesity on Total Knee Arthroplasty Revision Rate: Results from the Australian Orthopaedic Association National Joint Replacement Registry. J Bone Joint Surg Am. 2022; 104(15):1386-1392. doi:10.2106/JBJS.21.01491.
  8. Pierpont YN, Dinh TP, Salas RE, et al. Obesity and surgical wound healing: a current review. ISRN Obes. 2014; 2014:638936. doi:10.1155/2014/638936.
  9. Aggarwal VA, Sambandam S, Wukich D. The Impact of Obesity on Total Hip Arthroplasty Outcomes: A Retrospective Matched Cohort Study. Cureus. 2022; 14(7):e27450. doi:10.7759/cureus.27450.
  10. Blokhin IO, Lentz SR. Mechanisms of thrombosis in obesity. Curr Opin Hematol. 2013; 20(5):437-444. doi:10.1097/MOH.0b013e3283634443.
  11. Dowsey MM, Brown WA, Cochrane A, Burton PR, Liew D, Choong PF. Effect of Bariatric Surgery on Risk of Complications After Total Knee Arthroplasty: A Randomized Clinical Trial. JAMA Netw Open. 2022; 5(4):e226722. doi:10.1001/jamanetworkopen.2022.6722.
  12. Tummala SV, Verhey EM, Spangehl MJ, et al. Preoperative Postvoid Residual Is Not Predictive of Postoperative Urinary Retention in Primary Total Joint Arthroplasty Patients. Arthroplast Today. 2024; 26:101341. doi:10.1016/j.artd.2024.101341.
  13. Carlock KD, Mills ZD, Geiger KW, Manner PA, Fernando ND. Routine Indwelling Urinary Catheterization Is Not Necessary During Total Hip Arthroplasty Performed Under Spinal Anesthesia. Arthroplast Today. 2022; 16:68-72. doi:10.1016/j.artd.2022.04.015.
  14. Colin-Vázquez A, Galindo-Ávalos J, Salas-Alemán M, et al. Incidence and risk factors for acute kidney injury: a prospective, randomized, single-blind clinical trial comparing total knee arthroplasty with and without tourniquet. Acta Ortop Mex. 2021; 35(2):158-162.
  15. Jämsen E, Huhtala H, Puolakka T, Moilanen T. Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J Bone Joint Surg Am. 2009; 91(1):38-47. doi:10.2106/JBJS.G.01686.
  16. Feng S, Zhang Y, Zhang F, Yang Z, Chen XY, Zha GC. Are There Lower Complication Rates with Bidirectional Barbed Suture in Total Knee Arthroplasty Incision Closure? A Randomized Clinical Trial. Med Sci Monit. 2020; 26:e922783. doi:10.12659/MSM.922783.
  17. Comprehensive Care for Joint Replacement Model | CMS. Available at: https://www.cms.gov/priorities/innovation/innovation-models/cjr. Accessed April 20, 2024.
  18. Zomar BO, Marsh JD, Bryant DM, Lanting BA. The cost of outpatient versus inpatient total hip arthroplasty: a randomized trial. Can J Surg.2022; 65(5):E553-E561. doi:10.1503/cjs.003821.
  19. Leao DLL, Cremers HP, van Veghel D, Pavlova M, Groot W. The Impact of Value-Based Payment Models for Networks of Care and Transmural Care: A Systematic Literature Review. Appl Health Econ Health Policy. 2023; 21(3):441-466. doi:10.1007/s40258-023-00790-z.
  20. Doran JP, Beyer AH, Bosco J, et al. Implementation of Bundled Payment Initiatives for Total Joint Arthroplasty: Decreasing Cost and Increasing Quality. Instr Course Lect. 2016:65:555-66.

 

 

 

 

 

 



 



 

 



 

The Archives of Bone and Joint Surgery
Volume 13, Issue 2
February 2025
Pages 87-99

Files

History

  • Receive Date: 19 June 2024
  • Revise Date: 21 October 2024
  • Accept Date: 21 October 2024

Share

How to cite

Statistics