ArticleArthroplasty today2026
Quantifying the Opportunity Cost of Resident Involvement in Total Hip and Knee Arthroplasty.
Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Resident participation in total hip arthroplasty and total knee arthroplasty (THA/TKA) is important, but the time-driven financial impact remains unclear. We quantified the "opportunity cost" of resident involvement in THA and TKA. Methods: Primary THA and TKA cases were identified at a single academic center (2013-2017). Cases were attending-only (AO) or resident-involved (RI). Fellows excluded. RI was stratified between juniors (postgraduate year I-III) and seniors (postgraduate year IV-V). Outcomes included operative efficiency and financial productivity. Relative value units/case were fixed at 19.6 to isolate time-driven effects. Results: A total of 3,217 AO and 1,148 RI THA cases, and 4,174 AO and 1,235 RI TKA cases were analyzed. RI increased operative time (THA +4.0 minutes, 95% CI [2.3, 5.7]; TKA +7.9 minutes, 95% CI [6.7, 9.1]; both p<0.001) but reduced set-up time (THA -1.7 minutes, 95% CI [-2.2, -1.2]; TKA -1.6 minutes, 95% CI [-2.0, -1.2]; both p<0.001), partially offsetting total operating room (OR) time (THA +2.3 minutes; TKA +6.3 minutes). Juniors concentrated these effects. Seniors approximated AO efficiency and had quicker THA total OR times. Per-case opportunity costs were small: operative-time (THA $36.81; TKA $76.51) and total OR time (THA $15.16; TKA $7.22). Seniors showed a $12.99 per-case savings on a THA total OR time basis. Conclusions: Resident participation in primary THA/TKA carries small, experience-dependent costs, partially offset with seniority and quicker set-up times. These findings may reflect anticipatory workflow gains and offer insights into schedule optimization.
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