Referral Bias in Primary Total Knee Arthroplasty: Retrospective Analysis of 22,614 Surgeries in a Tertiary Referral Center

Abstract

Background: Patients who travel a significant distance to obtain surgical treatment typically experience better outcomes. This is called the referral bias and can limit the generalizability of studies performed at large tertiary care centers. We explored the influence of referral bias by comparing the clinical characteristics and outcomes of total knee arthroplasty (TKA) at a large tertiary care hospital in the United States.