Evidence map›Paper›PMID 40329015›Full record

ArticleInternational orthopaedics2025

The impact of "weekend effect" on the outcomes of total joint arthroplasty in the United States.

Amir Human Hoveidaei, Fatemeh Moosaie, Amirhossein Ghaseminejad-Raeini, Seyed Pouya Taghavi, Sina Esmaeili, Andrew Harris, Janet D Conway

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Article in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Amir Human HoveidaeiInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 W Belvedere Ave 2nd Floor, Baltimore, MD, 21215, USA. hoveidaei.a.h@gmail.com.ORCID http://orcid.org/0000-0003-4607-354X
Fatemeh MoosaieSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Amirhossein Ghaseminejad-RaeiniSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Pouya TaghaviSchool of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Sina EsmaeiliSina University Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Andrew HarrisDepartment of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Janet D ConwayInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 W Belvedere Ave 2nd Floor, Baltimore, MD, 21215, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn this study we aimed to identify the impact of the weekend effect on complications in patients undergoing total joint arthroplasty (TJA) including total knee arthroplasty (TKA) and total hip arthroplasty (THA) in the United States.

methodsThis study is a retrospective cohort study including patients who underwent total joint arthroplasty (i.e. TKA and THA) from 2010 to 2022 across the United States. Patient records were queried from PearlDiver. The 90-days surgical outcomes were compared between patients who had the surgery on weekends and those who underwent the operation on a weekdays.

resultsThe study consisted of 2,208,713 patients who underwent TJA; 1,374,018 and 834,695 with TKA and THA, respectively. Ninety-days' incidences of peri-prosthetic joint infection, implant loosening, pneumonia, sepsis, and readmission were higher after TKA surgeries performed on weekends compared to weekdays (OR (95%CI): 4.20 (3.25, 5.44), 2.62 (1.06, 6.45), 1.65 (1.11, 2.43), 3.65 (2.51, 5.29), and 3.14 (2.74, 3.61), respectively). As for THA surgeries, 90 days' incidence of per-prosthetic joint infection, peri-prosthetic fracture, acute renal failure, respiratory failure, sepsis, systemic complications, and readmission were higher among surgeries performed on weekends (OR (95%CI): 4.61 (3.63, 5.85), 2.00 (1.41, 2.83), 1.60 (1.21, 2.11), 1.73 (1.15, 2.60), 2.61 (1.86, 3.67), 1.21 (1.06, 1.39), and 4.12 (3.61, 4.71), respectively).

conclusionsTJAs performed on weekends carry higher risk of post-operative complications and poor surgical outcomes. Also, patients undergoing TJA on weekends have a higher prevalence of pre-existing risk factors and poorer baseline health conditions. Findings from this study suggest that access to adequate physical therapy and a rehabilitation centre staffed with skilled nurses on a seven day basis could mitigate complications in patients undergoing TJA during the weekends. Furthermore, high-risk patients should undergo their procedures when hospitals are most well-prepared.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneePostoperative ComplicationsAgedFemaleHumansMaleMiddle AgedPatient ReadmissionRetrospective StudiesTime FactorsTreatment OutcomeUnited StatesArthroplastySurgical outcomesTotal hip arthroplastyTotal knee arthroplastyWeekend effect

Identifiers

PMID40329015

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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.