SynthesisClinical orthopaedics and related research2012
Drivers of surgery for the degenerative hip, knee, and spine: a systematic review.
Synthesis in Clinical orthopaedics and related research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Does obesity affect the surgical outcome and complication rates of spinal surgery? A meta-analysis.Clinical orthopaedics and related research · 2014Pooled it
- Impact of Rurality on Total Joint Arthroplasty Access and Outcomes: A Systematic Review.Arthroplasty today · 2026Review
- Regional variation in the use of revascularisation for peripheral artery disease in Japan: a cross-sectional observational study.BMJ open · 2023Observational
- Rural-Urban Differences in Hospital and Patient-Reported Outcomes Following Total Hip Arthroplasty.Arthroplasty today · 2023Article
- Incidence of spine surgery in the South African private healthcare sector: ten-year trends within a large open medical scheme.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
- Article
- Cross-Cultural Adaptation and Validation of the Arabic Version of the Harris Hip Score.Arthroplasty today · 2023Article
- Does Time to Imaging and Surgery for Distal Radius Fractures Vary based on Geographic Socioeconomic Disadvantage?Hand (New York, N.Y.) · 2022Article
- Indication for spinal surgery: associated factors and regional differences in Germany.BMC health services research · 2022Article
- Explaining regional variation in elective hip and knee arthroplasties in Finland 2010 - 2017-a register-based cohort study.BMC health services research · 2022Article
- Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010-2020.Upsala journal of medical sciences · 2022Article
- Understanding Variation in Postacute Care: Developing Rehabilitation Service Areas Through Geographic Mapping.American journal of physical medicine & rehabilitation · 2021Article
- Article
- Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.Archives of physical medicine and rehabilitation · 2015Article
- Trends in the surgical treatment of articular cartilage defects of the knee in the United States.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2014Article
- Effect of obesity and clinical factors on pre-incision time: study of operating room workflow.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2014Article
- Heterogeneity in health status and the influence of patient characteristics across patients seeking musculoskeletal orthopaedic care - a cross-sectional study.BMC musculoskeletal disorders · 2013Article
- Income and patient-reported outcomes (PROs) after primary total knee arthroplasty.BMC medicine · 2013Article
- Clinically important body weight gain following total hip arthroplasty: a cohort study with 5-year follow-up.Osteoarthritis and cartilage · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical treatment for degenerative conditions of the hip, knee, and spine has an impact on overall healthcare spending. Surgical rates have increased dramatically and considerable regional variation has been observed. The reasons behind these increasing rates and variation across regions have not been well elucidated. QUESTIONS/PURPOSES: We therefore identified demographic (D), social structure (SS), health belief (HB), personal (PR) and community resources (CR), and medical need (MN) factors that drive rates of hip, knee, and spine surgery.
methodsWe conducted a systematic review to include all observational, population-based studies that compared surgical rates with potential drivers (D, SS, HB, PR, CR, MN). We searched PubMed combining key words focusing on (1) disease and procedure; (2) study methodology; and (3) explanatory models. Independent investigators selected potentially eligible studies from abstract review and abstracted methodological and outcome data. From an initial search of 256 articles, we found 37 to be potentially eligible (kappa 0.86) but only 28 met all our inclusion criteria.
resultsAge, nonminority, insurance coverage, and surgeon enthusiasm all increased surgical rates. Rates of arthroplasty were higher for females with higher education, income, obesity, rurality, willingness to consider surgery, and prevalence of disease, whereas spinal rates increased with male gender, lower income, and the availability of advanced imaging.
conclusionsRegional variation in these procedures exists because they are examples of preference-sensitive care. With strategies that may affect change in factors that are potentially modifiable by behavior or resources, extreme variation in rates may be reduced.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.