Live MediSum Demo

From 2014–2023 among 388 providers performing 6,263 TAAs for Medicare beneficiaries, podiatrists received slightly higher per-procedure reimbursements than orthopaedic surgeons but both specialties experienced marked real-term declines (24% for podiatrists, 18% for orthopaedic surgeons) with corresponding decreases in annual procedural income, raising concerns about practice sustainability and access.

This systematic review of 24 studies (10,394 radiographs) found that quantitative minimum joint space width (mJSW) measurements have higher inter- and intra-observer reliability (mean ICC ~0.82) than Kellgren-Lawrence grading (mean kappa ~0.72); reliability improved with expert or AI raters, semiflexed PA/Rosenberg views, and atlas training, supporting use of mJSW alongside KL grading.

This perspective argues that short-term arthroplasty missions often report only volume and early complications while neglecting durable quality measures such as implant survivorship, long-term follow-up, complication surveillance, revision capacity, implant traceability, capacity development, and financial transparency. The authors propose an accountability framework centered on these metrics to ensure episodic missions translate into sustained patient benefit and resilient local systems.