Travel Distance Does Not Affect Patient-Reported Outcomes Following Primary Total Knee Arthroplasty

An increasing volume of total knee arthroplasties (TKAs) is being performed at high-volume specialty centers. Concerns exist that this may increase travel burden for patients, which may result in fragmented postoperative care and impact outcomes. The purpose of this study was to evaluate the impact of travel distance on patient-reported outcomes (PROs) and change in range of motion (ROM).

Consecutive patients who underwent inpatient primary TKA by one surgeon at a tertiary care center between 2017 and 2022 were evaluated. Patients who had less than 90 days of follow-up were excluded. Patients who lived ≥ 50 miles from the operative location were labeled as "travelers," and those < 50 miles away were "locals." Primary outcomes included final change in ROM and PROs as measured by the Veterans Rand 12-Item Health Survey, Knee Society Score, and Knee Dysfunction and Osteoarthritis Outcome Score for Joint Replacement. Secondary outcomes included rates of 90-day medical complications, emergency department visits, unplanned readmissions, and reoperations. A total of 430 patients were analyzed at a mean of 737.2 days (range, 90 to 2,115), including 58 travelers.

There was no significant difference in the change in ROM between the two groups. There was no difference in the percentage of patients achieving a minimal clinically important difference in PROs. The rates of emergency department visits (travelers = 1.7%; locals = 2.2%; P = 0.83), 90-day readmissions (travelers = 3.4%; locals = 1.6%; P = 0.34), and 90-day reoperations (travelers = 1.7%; locals = 1.3%; P = 1.00) were similar between groups.

Travelers achieved minimal clinically important difference at similar rates compared to local patients who had no significant difference in 90-day complication rates or change in ROM. These results suggest that travel distance does not adversely affect PROs or 90-day complications following TKA.