Research in THA and TKA From the United States Has Declined Over the Past Decade Relative to Other Countries (OrthoSuperSite)
Our hypothesis is that there has been a decline in total hip arthroplasty (THA) and total knee arthroplasty (TKA) research in the United States relative to other countries over the past decade.
Decreasing reimbursement, increasing surgical volumes, and prohibitive institutional review board polices potentially deter residents from entering the subspecialty of joint replacement, while also inhibiting research production by existing surgeons.
All original research involving THA and TKA published in The Journal of Bone and Joint Surgery, American Volume, Journal of Arthroplasty, and Clinical Orthopaedics and Related Research over the past decade was queried. Country of origin and level of evidence of each publication were documented. From January 1999 to December 2008, 1724 original peer-reviewed research studies involving THA and TKA were identified. The percentage of publications from US institutions steadily declined from 65.8% in 1999 to 46.9% in 2008. The percentage of Level I and II studies from the United States increased from 9.7% in 1999 to 23....
