Same-Day Discharge Total Joint Arthroplasty: A Bibliometric Analysis

Document Type : RESEARCH PAPER

Authors

1 Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada

2 Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, Ontario, Canada

3 Division of Orthopaedics, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

10.22038/abjs.2025.88447.4009

Abstract

Objectives: Same-day discharge (SDD) total joint arthroplasty (TJA) continues to increase in prevalence globally, especially following the coronavirus disease (COVID-19) pandemic. The purpose of this analysis is to utilize bibliometric methodology to assess publication trends, key figures, and institutions, as well as geographic variations in SDD TJA research.
Methods: The Web of Science Core Collection was searched from inception to January 23, 2025, for studies on SDD TJA. Publication rates were assessed using the compound annual growth rate (CAGR) and segmented regression analysis. Top publishing authors, institutions, and countries were tabulated as frequencies. International collaboration was assessed by the prevalence of publications with authors from different nationalities.
Results: A total of 121 studies published between 2014 and 2024 were eligible for final analysis, with a CAGR of 44%. Segmented regression demonstrated a significant increase in slope pre-2023 to post-2023 (2.1 vs. 19 publications per year, R2=0.94, P<0.001). Original research comprised 83% of studies, with most being retrospective in nature (66%) and only three being of randomized controlled design (3%). Only four of 15 original studies with a designated primary outcome performed appropriate a priori sample size power analysis. Over half of the studies (53%) were published in the USA, with only seven studies (5.8%) demonstrating international collaboration.
Conclusion: SDD TJA research continues to grow at a rapid rate, with a nine-fold increase in publication rate since 2023. Future directions for SDD TJA research include research from varying healthcare delivery models, international collaborative efforts, and methodologically robust randomized controlled trials. 
        Level of evidence: V

Keywords

Main Subjects

References

  1. Konopka JF, Lee YY, Su EP, McLawhorn AS. Quality-Adjusted Life Years After Hip and Knee Arthroplasty: Health-Related Quality of Life After 12,782 Joint Replacements. JB JS Open Access. 2018;3(3):e0007. doi:10.2106/JBJS.OA.18.00007.
  2. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019;92:6-10. doi:10.1016/j.metabol.2018.09.005.
  3. Klug A, Gramlich Y, Rudert M, et al. The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years. Knee Surg Sports Traumatol Arthrosc. 2021;29(10):3287-3298. doi:10.1007/s00167-020-06154-7.
  4. Chen AZ, Shen TS, Bovonratwet P, Pain KJ, Murphy AI, Su EP. Total Joint Arthroplasty During the COVID-19 Pandemic: A Scoping Review with Implications for Future Practice. Arthroplast Today. 2021;8:15-23. doi:10.1016/j.artd.2020.12.028.
  5. Nowak LL, Schemitsch EH. Trends in Outpatient Total Knee Arthroplasty From 2012 to 2020. J Arthroplasty. 2023;38(6S):S21-S25. doi:10.1016/j.arth.2023.03.077.
  6. Rullán PJ, Xu JR, Emara AK, et al. Major National Shifts to Outpatient Total Knee Arthroplasties in the United States: A 10-Year Trends Analysis of Procedure Volumes, Complications, and Healthcare Utilizations (2010 to 2020). J Arthroplasty. 2023;38(7):1209-1216.e5. doi:10.1016/j.arth.2023.01.019.
  7. McClatchy SG, Rider CM, Mihalko WM, Pharr ZK, Toy PC. Defining Outpatient Hip and Knee Arthroplasties: A Systematic Review. J Am Acad Orthop Surg. 2021;29(8):e410-e415. doi:10.5435/JAAOS-D-19-00636.
  8. Debbi EM, Mosich GM, Bendich I, Kapadia M, Ast MP, Westrich GH. Same-Day Discharge Total Hip and Knee Arthroplasty: Trends, Complications, and Readmission Rates. J Arthroplasty. 2022;37(3):444-448.e1. doi:10.1016/j.arth.2021.11.023.
  9. Basques BA, Tetreault MW, Della Valle CJ. Same-Day Discharge Compared with Inpatient Hospitalization Following Hip and Knee Arthroplasty. J Bone Joint Surg Am. 2017;99(23):1969-1977. doi:10.2106/JBJS.16.00739.
  10. Huang A, Ryu JJ, Dervin G. Cost savings of outpatient versus standard inpatient total knee arthroplasty. Can J Surg. 2017;60(1):57-62. doi:10.1503/cjs.002516.
  11. Cross M, Smith E, Hoy D, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1323-1330. doi:10.1136/annrheumdis-2013-204763.
  12. Donthu N, Kumar S, Mukherjee D, Pandey N, Lim WM. How to conduct a bibliometric analysis: An overview and guidelines. Journal of business research. 2021;133:285-96.
  13. Boddu SP, Moore ML, Rodgers BM, Brinkman JC, Verhey JT, Bingham JS. A Bibliometric Analysis of the Top 100 Most Influential Studies on Robotic Arthroplasty. Arthroplast Today. 2023;22:101153. doi:10.1016/j.artd.2023.101153.
  14. Holzer LA, Holzer G. The most influential papers in unicompartmental knee arthroplasty. Knee Surg Relat Res. 2020;32(1):54. doi:10.1186/s43019-020-00072-1.
  15. Li C, Wu H, Sun Z, Chen Z, Trampuz A. Global Publication Trends and Research Hotspots of Revision Hip and Knee Arthroplasty: A 21-Year Bibliometric Approach. J Arthroplasty. 2022;37(5):974-984. doi:10.1016/j.arth.2022.01.022.
  16. Constantinescu DS, Lizardi JJ, Weinerman JR, Vandenberge D, Barnhill S, Hernandez VH. The Most Influential Publications in Outpatient Total Joint Arthroplasty. Orthop Rev (Pavia). 2022;14(3):38041. doi:10.52965/001c.38041.
  17. Boutros M, Nham FH, Corsi MP, et al. Bibliometric Analysis of Outpatient Hip and Knee Arthroplasty Research Evolution. Arch Bone Jt Surg. 2025;13(2):87-99. doi:10.22038/ABJS.2024.80590.3681.
  18. Zhai K, Ma W, Huang T. Hot spots and trends in knee revision research since the 21st century: a bibliometric analysis. Ann Transl Med. 2021;9(5):388-388. doi:10.21037/atm-20-3969.
  19. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. doi:10.1186/s13643-016-0384-4.
  20. 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.
  21. Klein GR, Posner JM, Levine HB, Hartzband MA. Same Day Total Hip Arthroplasty Performed at an Ambulatory Surgical Center: 90-Day Complication Rate on 549 Patients. J Arthroplasty. 2017;32(4):1103-1106. doi:10.1016/j.arth.2016.10.013.
  22. Gondusky JS, Choi L, Khalaf N, Patel J, Barnett S, Gorab R. Day of surgery discharge after unicompartmental knee arthroplasty: an effective perioperative pathway. J Arthroplasty. 2014;29(3):516-519. doi:10.1016/j.arth.2013.08.021.
  23. Bodrogi A, Dervin GF, Beaulé PE. Management of patients undergoing same-day discharge primary total hip and knee arthroplasty. CMAJ. 2020;192(2):E34-E39. doi:10.1503/cmaj.190182.
  24. Fraser JF, Danoff JR, Manrique J, Reynolds MJ, Hozack WJ. Identifying Reasons for Failed Same-Day Discharge Following Primary Total Hip Arthroplasty. J Arthroplasty. 2018;33(12):3624-3628. doi:10.1016/j.arth.2018.08.003.
  25. Bradley B, Middleton S, Davis N, et al. Discharge on the day of surgery following unicompartmental knee arthroplasty within the United Kingdom NHS. Bone Joint J. 2017;99-B(6):788-792. doi:10.1302/0301-620X.99B6.BJJ-2016-0540.R2.
  26. Scully RD, Kappa JE, Melvin JS. “Outpatient”-Same-calendar-day Discharge Hip and Knee Arthroplasty. J Am Acad Orthop Surg. 2020;28(20):e900-e909. doi:10.5435/JAAOS-D-19-00778.
  27. Kim KY, Feng JE, Anoushiravani AA, Dranoff E, Davidovitch RI, Schwarzkopf R. Rapid Discharge in Total Hip Arthroplasty: Utility of the Outpatient Arthroplasty Risk Assessment Tool in Predicting Same-Day and Next-Day Discharge. J Arthroplasty. 2018;33(8):2412-2416. doi:10.1016/j.arth.2018.03.025.
  28. Bedard NA, Elkins JM, Brown TS. Effect of COVID-19 on Hip and Knee Arthroplasty Surgical Volume in the United States. J Arthroplasty. 2020;35(7S):S45-S48. doi:10.1016/j.arth.2020.04.060.
  29. Gordon AM, Magruder ML, Conway CA, Sheth BK, Erez O. The Effect of COVID-19 on Elective Total Knee Arthroplasty Utilization, Patient Comorbidity Burden, and Complications in the United States: A Nationwide Analysis. J Am Acad Orthop Surg. 2022;30(24):e1599-e1611. doi:10.5435/JAAOS-D-22-00193.
  30. Rubinger L, Ekhtiari S, Gazendam A, Bhandari M. Registries: Big data, bigger problems? Injury. 2023;54 Suppl 3:S39-S42.doi:10.1016/j.injury.2021.12.016.
  31. Lee B, Ebrahimi M, Ektas N, et al. Implementation and quality assessment of a clinical orthopaedic registry in a public hospital department. BMC Health Serv Res. 2020;20(1):393. doi:10.1186/s12913-020-05203-8.
  32. Cundall-Curry DJ, Lawrence JE, Fountain DM, Gooding CR. Data errors in the National Hip Fracture Database: a local validation study. Bone Joint J. 2016;98-B(10):1406-1409. doi:10.1302/0301-620X.98B10.37089.33. Imam MA, Barke S, Stafford GH, Parkin D, Field RE. Loss to follow-up after total hip replacement: a source of bias in patient reported outcome measures and registry datasets? Hip Int. 2014;24(5):465-472. doi:10.5301/hipint.5000141.
  33. Baker PN, Jeyapalan R, Jameson SS. The value of national arthroplasty registry data in 2023. Bone Joint J. 2023;105-B(4):356-360. doi:10.1302/0301-620X.105B4.BJJ-2022-1190.R2.
  34. Liebs TR, Splietker F, Hassenpflug J. Is a Revision a Revision? An Analysis of National Arthroplasty Registries’ Definitions of Revision. Clin Orthop Relat Res. 2015;473(11):3421-3430. doi:10.1007/s11999-015-4255-4.
  35. Papanicolas I, Woskie LR, Jha AK. Health Care Spending in the United States and Other High-Income Countries. JAMA. 2018;319(10):1024-1039. doi:10.1001/jama.2018.1150.
  36. Porter ME. What is value in health care? N Engl J Med. 2010;363(26):2477-2481. doi:10.1056/NEJMp1011024.
  37. Porter ME. Value-based health care delivery. Ann Surg. 2008;248(4):503-509. doi:10.1097/SLA.0b013e31818a43af.
  38. Navathe AS, Troxel AB, Liao JM, et al. Cost of Joint Replacement Using Bundled Payment Models. JAMA Intern Med. 2017;177(2):214-222. doi:10.1001/jamainternmed.2016.8263.
  39. Pabinger C, Geissler A. Utilization rates of hip arthroplasty in OECD countries. Osteoarthritis Cartilage. 2014;22(6):734-741. doi:10.1016/j.joca.2014.04.009.
  40. Pabinger C, Lothaller H, Geissler A. Utilization rates of knee-arthroplasty in OECD countries. Osteoarthritis and Cartilage. 2015;23(10):1664-1673. doi:10.1016/j.joca.2015.05.008.
  41. Button KS, Ioannidis JPA, Mokrysz C, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci. 2013;14(5):365-376. doi:10.1038/nrn3475.
  42. Walsh M, Srinathan SK, McAuley DF, et al. The statistical significance of randomized controlled trial results is frequently fragile: a case for a Fragility Index. J Clin Epidemiol. 2014;67(6):622-628. doi:10.1016/j.jclinepi.2013.10.019.
  43. Bradbury TL, McConnell MJ, Whitacre D, Naylor BH, Gibson BT, DeCook CA. A Remote Physical Therapy Program Demonstrates Similar Outcomes Compared to In-Person, Supervised Physical Therapy After Same-Day Discharge Total Knee Arthroplasty: A Randomized Clinical Trial. J Arthroplasty. 2024;39(11):2725-2730.e4. doi:10.1016/j.arth.2024.05.040.
  44. Choi JW, Lahori A, Merlo JA, et al. Adductor Canal Blocks With Bupivacaine and Magnesium After Same-day Discharge Total Knee Arthroplasty Improve Postoperative Pain Relief and Decrease Opioid Consumption: A Prospective Randomized Controlled Trial. Clin J Pain. 2022;38(6):388-395. doi:10.1097/AJP.0000000000001036.
  45. Shi Y, Zhu P, Jia J, et al. Cost-effectiveness of Same-day Discharge Surgery for Primary Total Hip Arthroplasty: A Pragmatic Randomized Controlled Study. Front Public Health. 2022;10:825727. doi:10.3389/fpubh.2022.825727.
  46. Böhm K, Schmid A, Götze R, Landwehr C, Rothgang H. Five types of OECD healthcare systems: empirical results of a deductive classification. Health Policy. 2013;113(3):258-269. doi:10.1016/j.healthpol.2013.09.003.
  47. World Bank Country and Lending Groups. The World Bank. Available at: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups. Accessed February 23, 2005.
  48. Flores MJ, MacKechnie MC, Brown KE, et al. The Current State of International Academic Partnerships in Orthopaedic Surgery Between High-Income and Low and Middle-Income Countries: A Systematic Review. JB JS Open Access. 2024;9(3):e24.00033. doi:10.2106/JBJS.OA.24.00033.
  49. Van Horne A, Van Horne J. Presurgical optimization and opioid-minimizing enhanced recovery pathway for ambulatory knee and hip arthroplasty: postsurgical opioid use and clinical outcomes. Arthroplast Today. 2020;6(1):71-76. doi:10.1016/j.artd.2019.08.010.
  50. Page BM, Urbach DR, Wolfstadt JI, Clavel N, Brull R. Beast of burden? Understanding the impact of outpatient total hip and knee replacement on caregivers at home. Can J Anaesth. 2022;69(4):423-426. doi:10.1007/s12630-021-02140-w.
  51. Gabor JA, Singh V, Schwarzkopf R, Davidovitch RI. Similar Outcomes After Hospital-Based Same-Day Discharge vs Inpatient Total Hip Arthroplasty. Arthroplast Today. 2020;6(3):451-456. doi:10.1016/j.artd.2020.05.008.
  52. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336-341. doi:10.1016/j.ijsu.2010.02.007.
The Archives of Bone and Joint Surgery
Volume 14, Issue 4
April 2026
Pages 295-306

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History

  • Receive Date: 25 May 2025
  • Revise Date: 14 November 2025
  • Accept Date: 03 November 2025

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