Economic analyses of fast-track total hip and knee arthroplasty: a systematic review

  • Matthias BüttnerEmail author
  • Anica M. Mayer
  • Britta Büchler
  • Ulrich Betz
  • Philipp Drees
  • Singer Susanne
General Review • HIP - ARTHROPLASTY



The number of total hip (THA) and knee arthroplasties (TKA) grows constantly which causes enormously rising costs for healthcare systems. The aim of this systematic literature review was to evaluate whether a cost reduction can be achieved by THA or TKA fast-track protocols, which is a multidisciplinary approach aiming at faster recovery.


A systematic literature research was undertaken for the timeframe from 2007/01/01 to 2019/03/04 in PubMed. Abstracts and title of the identified records were checked for eligible criteria and afterward the full text was assessed.


Seven studies were included in the review. All studies showed a reduction in the total cost for fast-track THA and TKA. Most studies based their cost calculations on the amount of days the patients spend in the hospital.


Using a fast-track protocol can significantly reduce the overall costs of the treatment.


Fast-track Total hip arthroplasty Total knee arthroplasty Cost-effectiveness Cost analysis 


Authors’ contributions

All authors contributed to the conception and design of the study. All authors participated in critically revising the manuscript and all authors’ approved the final version of the manuscript for submission. Anica Mayer and Matthias Büttner performed the literature search. Anica Mayer and Matthias Büttner interpreted the data and drafted the manuscript. Anica Mayer and Britta Büchler performed the quality assessment of the studies.


This study did not receive any funding or grants.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animals rights

No research involving human participants and/or animals was carried out.

Informed consent

No informed consent was obtained, due to the nature of the study being a systematic review.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI)University Medical Center MainzMainzGermany
  2. 2.Institute of Physical Therapy, Prevention and RehabilitationUniversity Medical Center MainzMainzGermany
  3. 3.Center for Orthopedics and Trauma SurgeryUniversity Medical Center MainzMainzGermany

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