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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Related Experiment Video

Updated: Oct 20, 2025

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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Primary Care Provider Density and Elective Total Joint Replacement Outcomes.

Bella Mehta1,2, Collin Brantner1, Nicholas Williams3

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PubMed
Summary

Primary care physician (PCP) density did not significantly impact total knee (TKA) and total hip arthroplasty (THA) outcomes for osteoarthritis patients. This suggests other factors may influence patient success after joint replacement surgery.

Keywords:
Primary care physiciansProvider densityTotal hip arthroplastyTotal knee arthroplastyWOMAC

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Area of Science:

  • Orthopedics
  • Health Services Research
  • Public Health

Background:

  • Primary care physicians (PCPs) act as gatekeepers to specialist care.
  • Understanding the impact of PCP availability on surgical outcomes is crucial for healthcare planning.

Purpose of the Study:

  • To assess the relationship between PCP density and outcomes following total knee arthroplasty (TKA) and total hip arthroplasty (THA).

Main Methods:

  • Patient-level data from an institutional registry for elective primary TKA and THA due to osteoarthritis.
  • Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, function, and stiffness were collected at baseline and 2 years.
  • Geocoding was used to determine PCP density within patient census tracts, with statistical analyses adjusting for confounders.

Main Results:

  • The study included 3606 TKA and 4295 THA cases.
  • No statistically significant differences in WOMAC scores were observed between communities with higher vs. lower than median PCP density.
  • Sensitivity analyses indicated that increasing PCP density in underserved areas did not significantly improve outcomes.

Conclusions:

  • No statistically significant association was found between PCP density and pain, function, or stiffness outcomes at baseline or 2 years post-TKA/THA.
  • Further research is needed to identify other provider-related factors influencing access and outcomes in TKA and THA patients.