Evidence map›Paper›PMID 41993228›Full record

ReviewArthroplasty today2026

Impact of Rurality on Total Joint Arthroplasty Access and Outcomes: A Systematic Review.

Sean L Agrodnia, Catherine M Call, Andrew D Lachance, John C McDonald, Adam J Rana, Brian J McGrory

Abstract readReview
In one paragraph

Review 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.

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

6 authors.

Sean L AgrodniaTufts University School of Medicine, Boston, MA, USA.
Catherine M CallDepartment of Orthopedic Surgery, Brown University, Providence, RI, USA.
Andrew D LachanceDepartment of Orthopedic Surgery, Guthrie Clinic, Sayre, PA, USA.
John C McDonaldDepartment of Orthopedics and Physical Rehabilitation, UMassMemorial Medical Center, Worchester, MA, USA.
Adam J RanaTufts University School of Medicine, Boston, MA, USA.
Brian J McGroryTufts University School of Medicine, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Total joint arthroplasty (TJA) is one of the most frequent orthopaedic surgeries in the United States; however, disparities in utilization and outcomes based on race, sex, and socioeconomic level have been well documented. The impact of rural geographic location, a characteristic that may impact access to TJA care and postoperative outcomes, remains understudied. This systematic review investigated associations between rural location and several metrics in total hip arthroplasty and total knee arthroplasty to investigate whether disparities are present based on rural geographic location. Methods: In November 2024, PubMed, Web of Science, Scopus, EMBASE, and Cochrane Review databases were queried. Ten studies investigating TJA utilization and outcomes that included patients in a rural location were included. Study quality was assessed using a modified Newcastle-Ottawa Scale. Results: Ten articles were included in the final analysis. Differences in complications, readmission rates, and length of stay due to rural location of patient and/or hospital were reported. Results indicate urban TJA patients more frequently discharge to rehab. Patient-reported outcome measures following TJA do not appear different between rural and urban patient groups. Conclusions: Rural geographic location is associated with different TJA utilization and outcomes and may point to disparities in care. Continued efforts dedicated to eliminating inequalities in TJA care should consider the impact geographic location may have on exacerbating other forms of inequity. The reporting of urban-rural classification of patients in arthroplasty research is important for advancing this area of study. Access to care for all patients should be prioritized.

Indexed as

AccessHealth-care equityOutcomesPROMsRuralTotal hip arthroplastyTotal knee arthroplasty

Identifiers

PMID41993228
PMCPMC13081216

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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.