A scoping review of factors influencing prosthesis selection for knee and hip arthroplasties: perspectives of surgeons in high income countries

Abstract

Abstract Purpose Hip and knee arthroplasties in high income countries are common and costly. A substantial proportion of the costs associated with these surgeries are attributable to the prosthesis chosen by surgeons. The objective of this scoping review was to identify ‘What are the factors influencing surgeons’ prosthesis selection for knee and hip arthroplasty in high-income countries?’ Methods Four databases of peer reviewed literature (Embase, PubMed, CINAHL, and Web of Science) and two grey literature searches (Policy Commons and Overton) were conducted. Papers were included if they evaluate opinions or experiences of surgeons concerning prosthesis selection for hip or knee arthroplasty and published in English. Factors influencing prosthesis selection were categorised into the domains of patient advantage, surgeon-related, prosthesis quality, vendor or service-related, cost considerations, and information source. Results A total of 2572 unique articles were identified and screened, four studies were eligible for inclusion. Consideration of cost and patient benefit were noted across included studies. Several other factors were outlined including familiarity with prostheses, relationship with the vendor, or prosthesis reputation, but the relative extent to which these factors contribute to decision making is unclear. Conclusion Despite a relative scarcity of studies investigating factors influencing surgeon’s prosthesis selection choices, multiple factors were identified for further exploration. A greater understanding the perspectives of surgeons is needed for the effective development and implementation of any hospital or system-level policies for reducing arthroplasty costs and improving patient outcomes.