Evidence map›Paper›PMID 40336955›Full record

ArticleArthroplasty today2025

Increased Body Mass Index is Associated With Increased Cost for Primary Total Knee Arthroplasty Exclusive of Readmissions and Complications.

Bryce E Maxwell, Kranti C Rumalla, Isaac Sontag-Milobsky, Austin R Chen, T Jacob Selph, Adam I Edelstein

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. 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

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

6 authors.

Bryce E MaxwellNorthwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Kranti C RumallaNorthwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Isaac Sontag-MilobskyNorthwestern University, Department of Orthopaedic Surgery, Chicago, IL, USA.
Austin R ChenNorthwestern University, Feinberg School of Medicine, Chicago, IL, USA.
T Jacob SelphNorthwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Adam I EdelsteinNorthwestern University, Department of Orthopaedic Surgery, Chicago, IL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Surgeons participating in alternative payment models may encounter financial disincentives in caring for high-cost patients. While prior studies have shown a relationship between body mass index (BMI) and cost in total knee arthroplasty (TKA), this question has not been examined using recent data in a nationally-representative dataset. We sought to use recent data to assess the relationship between BMI and cost in TKA. Methods: We queried the 2016-2022 PINC AI Healthcare Dataset for primary TKAs identified by the Current Procedural Terminology code 27447. Baseline patient demographics, characteristics, and outcomes were gathered. Patient costs included index and 90-day period costs starting from the surgical encounter. A multivariate generalized linear model estimated patient costs across eight BMI categories (WHO BMI categories, with BMI >40 grouped into BMI 40-45, BMI 45-50, and BMI >50), and a linear regression model assessed the effect of BMI on costs. Both models controlled for age, sex, payer, race, ethnicity, and Elixhauser Comorbidity Index. Results: A total of 24,064 primary TKAs were included. Patient characteristics were age (mean 68 years, SE 0.06), sex (62.3% female), payer (63.8% Medicare), race (88.6% white), ethnicity (3.1% Hispanic), and Elixhauser Comorbidity Index (mean 2.07, SE 0.01). The mean BMI was 32.0 (SE 0.1), with mean index and 90-day costs of $14,051 ± $32.6 and $17,377 ± 107.3, respectively. Predicted patient index and 90-day costs were both highest in the BMI >50.0 category at $15,555 and $20,716, respectively. Predicted index and 90-day costs were lowest in the 25.0-29.9 ($13,765) and <18.5 ($16,403) categories, respectively. The multivariate analysis showed that patient index and 90-day costs increased by $23.20 ( Conclusions: Higher patient BMI is associated with increased index and 90-day episodic costs for primary TKA. Stakeholders may consider incorporating this information in bundled payment models and other value-based reimbursement models.

Indexed as

Alternative payment modelsBody mass indexCost of careEconomicsTotal knee arthroplasty

Identifiers

PMID40336955
PMCPMC12056797

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LicenceCC BY-NC-ND
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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.