The Journal of Hip Surgery 2023; 07(03): 133-140
DOI: 10.1055/s-0043-1771247
Original Article

Weekend versus Weekday Procedures for Total Hip Arthroplasties

Shawn Okpara
1   Department of Orthopaedics, Baylor College of Medicine, Houston, Texas
Abdullah Ghali
1   Department of Orthopaedics, Baylor College of Medicine, Houston, Texas
David Momtaz
2   Department of Neurosurgery, UT Health San Antonio, San Antonio, Texas
Tucker Cushing
1   Department of Orthopaedics, Baylor College of Medicine, Houston, Texas
Travis Kotzur
2   Department of Neurosurgery, UT Health San Antonio, San Antonio, Texas
1   Department of Orthopaedics, Baylor College of Medicine, Houston, Texas
Parker Mitchell
1   Department of Orthopaedics, Baylor College of Medicine, Houston, Texas
3   Department of Orthopaedics, John D. Dingell VA Medical Center Detroit, Detroit, Michigan
Varun Bora
2   Department of Neurosurgery, UT Health San Antonio, San Antonio, Texas
Ali Seifi
2   Department of Neurosurgery, UT Health San Antonio, San Antonio, Texas
Khaled J. Saleh
3   Department of Orthopaedics, John D. Dingell VA Medical Center Detroit, Detroit, Michigan
› Author Affiliations


The “weekend effect” is the phenomenon that claims increased adverse outcomes for weekend procedures compared to weekday procedures. However, there is significant controversy regarding such disparities in elective orthopaedic surgeries. With the increasing demand for hip arthroplasty projected over the next 20 years, it is important to investigate a possible “weekend effect” to optimize outcomes and cost-effectiveness. In this study, we investigate the association between weekday versus weekend total hip arthroplasty (THA) and postoperative outcomes using the Healthcare Cost and Utilization Project (HCUP) data. We performed a retrospective analysis of the HCUP database between 2002 and 2020 comparing THAs done Monday to Friday versus THAs done Saturday to Sunday. Data collected included patient demographics and comorbidities, hospital length of stay, admission to procedure time, discharge disposition, mortality, and outcome data through postoperative day 30. THAs performed on weekends were associated with significantly increased length of stay, total charges, admission-to-procedure time, and mortality compared to those on weekdays. Our findings suggest that the development of nationwide programs to standardize care and weekend case management for THA patients can potentially help reduce health care costs, improve operative outcomes, and reduce the discrepancy between weekend and weekday surgeries.

Publication History

Received: 01 March 2023

Accepted: 07 June 2023

Article published online:
24 July 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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