Evidence map›Paper›PMID 40226785›Full record

ArticleArthroplasty today2025

State Healthcare Regulations and Total Knee Arthroplasty Prices Across the United States.

Kevin A Wu, Katherine M Kutzer, Christian A Pean, Thorsten M Seyler

Abstract read
In one paragraph

Article in Arthroplasty today, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kevin A WuDepartment of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
Katherine M KutzerDepartment of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
Christian A PeanDepartment of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
Thorsten M SeylerDepartment of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The cost of healthcare services in the United States is subject to various regulatory influences, yet the impact of state-level healthcare policies and political affiliations on total knee arthroplasty (TKA) prices remains underexplored. Methods: Using data from the Turquoise Health Database and publicly available sources, TKA prices were analyzed across states to examine the influence of Medicaid expansion, Certificate of Need (CON) laws, and state partisan lean. Multivariable regression models controlled for Gross Domestic Product per capita, Area Deprivation Index, and urbanization. Results: Among 64,402 TKAs from 2455 hospitals ($18,164 median, interquartile range: $10,806), states with Medicaid expansion and CON laws demonstrated lower TKA prices. Republican-leaning states had significantly reduced TKA prices compared to Democrat-leaning states, even after adjusting for economic factors ( Conclusions: Medicaid expansion and CON laws were associated with lower TKA prices across the United States. Additionally, states with Republican political leanings tended to have lower listed prices for TKA compared to Democrat-leaning states. These findings underscore the substantial influence of state healthcare policies and political factors on healthcare costs, highlighting the complexities of pricing dynamics in the US healthcare system. Level of evidence: IV.

Indexed as

Certificate of needHealthcare costsMedicaid expansionPolitical affiliationState healthcare regulationsTotal knee arthroplasty

Identifiers

PMID40226785
PMCPMC11986227

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Registered trials

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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.