Managing manageable access to high-quality care for revision total joint arthroplasty (rTJA) is absolutely imperative, especially in context-heavy cases like periprosthetic joint infection or aseptic failure causing profound patient pain and disability. As value-based healthcare programs expand, interest in the social determinants of health has risen across specialized orthopedic literature. In a purely equitable healthcare environment, one uninfluenced by structural referral bias- insurance type would share no systematic relationship with hospital travel distance or local surgeon sorting behavior.
Unfortunately, contemporary healthcare economics tell a vastly different story. While elective primary total joint replacements are frequently executed close to a patient’s home, individuals requiring highly complex secondary revision reconstructions routinely experience severe regional access constraints. We set out to rigorously evaluate travel burdens following hip and knee revisions to determine if a patient’s insurance profile directly controls their structural access to localized orthopedic care.
