Perioperative practice variations between university and private hospitals in total knee arthroplasty: a retrospective comparative study

Objective: Differences in healthcare delivery between university and private hospitals may influence perioperative management practices in orthopedic surgery. However, objective data comparing these settings in Türkiye remain limited. This study aimed to evaluate the differences in perioperative management practices, consultation patterns, and anesthesia strategies among patients undergoing total knee arthroplasty (TKA).

Methods: In this retrospective study, 151 patients who underwent unilateral TKA between October 2018 and October 2021 were analyzed. All procedures were performed by a single surgeon at either a university hospital or a private hospital. Demographic and clinical characteristics, comorbidities, anesthesia type, consultation rates, and length of hospital stay were compared between groups. Statistical analyses were conducted using SPSS, with P < .05 considered statistically significant.

Results: A total of 151 patients (mean age = 67.8 years) were included, of whom 57.6% were treated at a university hospital. Patients treated in private hospitals had a significantly higher prevalence of comorbidities than those treated in university hospitals (76.6% vs. 48.3%, P < .001). Consultation rates were higher in university hospitals (49.4% vs. 29.7%, P = .015), and consultations more frequently resulted in changes in patient management (18.4% vs. 4.7%, P = .019). General anesthesia was more commonly used in university hospitals (9.2% vs. 1.6%, P = .048), whereas spinal/epidural anesthesia predominated in private hospitals.

Conclusion: Significant differences exist between university and private hospitals in perioperative management strategies, consultation practices, and anesthesia use during TKA. These findings suggest differences in institutional workflows and perioperative decision-making approaches between healthcare settings. Understanding such variations may contribute to future standardization efforts and optimization of perioperative care in orthopedic practice.

Cite this article as: Koken M, Gumus D, Akan B. Perioperative practice variations between university and private hospitals in total knee arthroplasty: a retrospective comparative study. Acta Orthop Traumatol Turc., 2026; 60(4), 0991, doi: 10.5152/j.aott.2026.26991.