{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:50:15Z","timestamp":1792068615702,"version":"4.4.0"},"reference-count":25,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2027,6,29]],"date-time":"2027-06-29T00:00:00Z","timestamp":1814227200000},"content-version":"am","delay-in-days":363,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100000069","name":"NIAMS","doi-asserted-by":"publisher","award":["P30AR76312"],"award-info":[{"award-number":["P30AR76312"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroplastyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.arth.2026.01.082","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T20:42:13Z","timestamp":1774989733000},"page":"S134-S140","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S1","title":["Surgeon Variation Is Likely the Primary Confounding Factor in Observational Studies of Technology Use in Total Knee Arthroplasty"],"prefix":"10.1016","volume":"41","author":[{"given":"Jacob L.","family":"Brennan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Edson","family":"De Guzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haryoung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"McVey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy M.","family":"Novicoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0367-7976","authenticated-orcid":false,"given":"James A.","family":"Browne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2026.01.082_bib1","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.3899\/jrheum.170990","article-title":"Rates of total joint replacement in the United States: future projections to 2020\u20132040 using the national Inpatient sample","volume":"46","author":"Singh","year":"2019","journal-title":"J Rheumatol"},{"key":"10.1016\/j.arth.2026.01.082_bib2","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s11999-009-1119-9","article-title":"Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?","volume":"468","author":"Bourne","year":"2010","journal-title":"Clin Orthop"},{"key":"10.1016\/j.arth.2026.01.082_bib3","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.otsr.2017.04.017","article-title":"Quality of life after total knee arthroplasty","volume":"104","author":"Canovas","year":"2018","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.arth.2026.01.082_bib4","doi-asserted-by":"crossref","first-page":"S54","DOI":"10.1016\/j.arth.2024.07.028","article-title":"Technology in total Knee Arthroplasty in 2023","volume":"39","author":"Pagan","year":"2024","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2026.01.082_bib5","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1016\/j.arth.2023.12.015","article-title":"Lower perioperative complication rates and shorter lengths of Hospital stay associated with technology-assisted total knee arthroplasty versus conventional instrumentation in primary total knee arthroplasty","volume":"39","author":"Constantinescu","year":"2024","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2026.01.082_bib6","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.artd.2021.02.015","article-title":"Trends in operative time and short-term outcomes after conventional and navigated total knee arthroplasty","volume":"8","author":"Sekimura","year":"2021","journal-title":"Arthroplasty Today"},{"key":"10.1016\/j.arth.2026.01.082_bib7","doi-asserted-by":"crossref","DOI":"10.5435\/JAAOSGlobal-D-22-00089","article-title":"Revisiting short-term outcomes of conventional and computer-assisted total knee arthroplasty: a population-based Study","volume":"6","author":"Ahmed","year":"2022","journal-title":"JAAOS Glob Res Rev"},{"key":"10.1016\/j.arth.2026.01.082_bib8","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1007\/s00167-022-06966-9","article-title":"Decreased patient comorbidities and post-operative complications in technology-assisted compared to conventional total knee arthroplasty","volume":"31","author":"O\u2019Rourke","year":"2023","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.arth.2026.01.082_bib9","doi-asserted-by":"crossref","first-page":"2677","DOI":"10.1007\/s00167-021-06464-4","article-title":"Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta-analysis","volume":"30","author":"Zhang","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.arth.2026.01.082_bib10","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1302\/0301-620X.100B7.BJJ-2017-1449.R1","article-title":"Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty","volume":"100-B","author":"Kayani","year":"2018","journal-title":"Bone Jt J"},{"key":"10.1016\/j.arth.2026.01.082_bib11","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1007\/s00167-020-06038-w","article-title":"Better accuracy and reproducibility of a new robotically-assisted system for total knee arthroplasty compared to conventional instrumentation: a cadaveric study","volume":"29","author":"Seidenstein","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.arth.2026.01.082_bib12","doi-asserted-by":"crossref","first-page":"S233","DOI":"10.1016\/j.arth.2021.02.038","article-title":"Minimal clinically important difference in robotic-assisted total knee arthroplasty versus standard manual total knee arthroplasty","volume":"36","author":"Shaw","year":"2021","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2026.01.082_bib13","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1016\/j.arth.2019.04.007","article-title":"Robot-Assisted total knee arthroplasty does not improve long-term clinical and radiologic outcomes","volume":"34","author":"Jeon","year":"2019","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2026.01.082_bib14","doi-asserted-by":"crossref","first-page":"82","DOI":"10.4055\/cios21138","article-title":"No difference in clinical outcomes and survivorship for robotic, navigational, and conventional primary total knee arthroplasty with a minimum Follow-up of 10 years","volume":"15","author":"Lee","year":"2023","journal-title":"Clin Orthop Surg"},{"key":"10.1016\/j.arth.2026.01.082_bib15","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/CORR.0000000000000916","article-title":"Does robotic-assisted TKA result in better outcome scores or long-term survivorship than conventional TKA? A randomized, controlled trial","volume":"478","author":"Kim","year":"2020","journal-title":"Clin Orthop"},{"key":"10.1016\/j.arth.2026.01.082_bib16","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s11999.0000000000000000","article-title":"2017 Chitranjan S. Ranawat award: does computer navigation in knee arthroplasty improve functional outcomes in young patients? A randomized Study","volume":"476","author":"Kim","year":"2018","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2026.01.082_bib17","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.knee.2020.12.015","article-title":"Reduced postoperative morbidity in computer-navigated total knee arthroplasty: a retrospective comparison of 225,123 cases","volume":"30","author":"Webb","year":"2021","journal-title":"The Knee"},{"key":"10.1016\/j.arth.2026.01.082_bib18","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1186\/1471-2474-13-250","article-title":"The role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature","volume":"13","author":"Lau","year":"2012","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.arth.2026.01.082_bib19","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1097\/CORR.0000000000002007","article-title":"What can we learn from surgeons who perform THA and TKA and have the lowest revision rates? A Study from the Australian orthopaedic Association national joint replacement registry","volume":"480","author":"Hoskins","year":"2022","journal-title":"Clin Orthop"},{"key":"10.1016\/j.arth.2026.01.082_bib20","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.2106\/JBJS.22.01351","article-title":"The effect of surgeon volume on revision for periprosthetic joint infection: an analysis of 602,919 primary total knee arthroplasties","volume":"105","author":"Vaotuua","year":"2023","journal-title":"JBJS"},{"key":"10.1016\/j.arth.2026.01.082_bib21","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.2106\/00004623-200409000-00008","article-title":"Association between hospital and surgeon procedure volume and the outcomes of total knee replacement","volume":"86","author":"Katz","year":"2004","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2026.01.082_bib22","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1302\/0301-620X.103B6.BJJ-2020-2287.R1","article-title":"High-volume revision surgeons have better outcomes following revision total knee arthroplasty","volume":"103-B","author":"Roof","year":"2021","journal-title":"Bone Jt J"},{"key":"10.1016\/j.arth.2026.01.082_bib23","first-page":"155","article-title":"Operative time and risk of surgical site infection and periprosthetic joint infection: a systematic review and meta-analysis","volume":"42","author":"Scigliano","year":"2022","journal-title":"Iowa Orthop J"},{"key":"10.1016\/j.arth.2026.01.082_bib24","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.arth.2019.01.027","article-title":"Longer operative time results in a higher rate of subsequent periprosthetic joint infection in patients undergoing primary joint arthroplasty","volume":"34","author":"Wang","year":"2019","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2026.01.082_bib25","doi-asserted-by":"crossref","first-page":"S331","DOI":"10.1016\/j.arth.2018.11.022","article-title":"Is operative time a predictor for post-operative infection in primary total knee arthroplasty?","volume":"34","author":"Anis","year":"2019","journal-title":"J Arthroplasty"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540326001087?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540326001087?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:10:00Z","timestamp":1792066200000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883540326001087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["S0883540326001087"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2026.01.082","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Surgeon Variation Is Likely the Primary Confounding Factor in Observational Studies of Technology Use in Total Knee Arthroplasty","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2026.01.082","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}