Beyond Case Counts: Defining Quality and Accountability in Short-Term Arthroplasty Missions.

Abstract

Short-term surgical missions have expanded access to total joint arthroplasty (TJA) in regions where degenerative joint disease remains undertreated. Reports from these initiatives frequently highlight procedural volume and low early complication rates, reinforcing the perception of success. However, these metrics capture only the earliest phase of outcome assessment following TJA. Durable arthroplasty quality is defined by implant survivorship, complication surveillance, revision capacity, and longitudinal follow-up. In many short-term mission models, long-term tracking, implant traceability, and local capacity for complication management are described incompletely. Without standardized benchmarks, the orthopaedic community risks equating surgical throughput with sustained impact. This article examines the limitations of the current reporting practices in mission-based arthroplasty and proposes an accountability framework that is centered on safety surveillance, follow-up infrastructure, implant traceability, revision capability, capacity development, and financial transparency. As global TJA efforts expand, defining meaningful quality metrics is essential to ensure that episodic interventions translate into durable patient benefit and resilient local systems.