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Review
. 2022 Dec;9(6):2317-2322.
doi: 10.1007/s40615-021-01168-4. Epub 2021 Oct 12.

What Factors Lead to Racial Disparities in Outcomes After Total Knee Arthroplasty?

Daniel A Hu #  1 , James B Hu #  2 , Ariel Lee  2 , William J Rubenstein  3 , Kevin M Hwang  3 , Said A Ibrahim  4 , Alfred C Kuo  5   6
Affiliations
Review

What Factors Lead to Racial Disparities in Outcomes After Total Knee Arthroplasty?

Daniel A Hu et al. J Racial Ethn Health Disparities. 2022 Dec.

Abstract

Total knee arthroplasty (TKA) is one of the most commonly performed, major elective surgeries in the USA. African American TKA patients on average experience worse clinical outcomes than whites, including lower improvements in patient-reported outcomes and higher rates of complications, hospital readmissions, and reoperations. The mechanisms leading to these racial health disparities are unclear, but likely involve patient, provider, healthcare system, and societal factors. Lower physical and mental health at baseline, lower social support, provider bias, lower rates of health insurance coverage, higher utilization of lower quality hospitals, and systemic racism may contribute to the inferior outcomes that African Americans experience. Limited evidence suggests that improving the quality of surgical care can offset these factors and lead to a reduction in outcome disparities.

Keywords: Clinical outcomes; Racial health disparity; Readmission; Total knee arthroplasty.

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Conflict of interest statement

The authors declare no competing interests.

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References

    1. Shahid H, Singh JA. Racial/ethnic disparity in rates and outcomes of total joint arthroplasty. Curr Rheumatol Rep. 2016;18(4):20. doi: 10.1007/s11926-016-0570-3. - DOI - PubMed
    1. Mehta B, Ho K, Bido J, Memtsoudis SG, Parks ML, Russell L, Goodman SM, Ibrahim S. Bilateral vs unilateral total knee arthroplasty: racial variation in utilization and in-hospital major complication rates. J Arthroplasty. 2020;S0883–5403(20):31156–31166. doi: 10.1016/j.arth.2020.10.057. - DOI - PMC - PubMed
    1. Bass AR, McHugh K, Fields K, Goto R, Parks ML, Goodman SM. Higher total knee arthroplasty revision rates among United States Blacks than Whites: a systematic literature review and meta-analysis. J Bone Joint Surg Am. 2016;98(24):2103–2108. doi: 10.2106/JBJS.15.00976. - DOI - PubMed
    1. Zhang W, Lyman S, Boutin-Foster C, Parks ML, Pan TJ, Lan A, Ma Y. Racial and ethnic disparities in utilization rate, hospital volume, and perioperative outcomes after total knee arthroplasty. J Bone Joint Surg Am. 2016;98(15):1243–1252. doi: 10.2106/JBJS.15.01009. - DOI - PubMed
    1. Goodman SM, Parks ML, McHugh K, Fields K, Smethurst R, Figgie MP, Bass AR. Disparities in outcomes for African Americans and Whites undergoing total knee arthroplasty: a systematic literature review. J Rheumatol. 2016;43(4):765–770. doi: 10.3899/jrheum.150950. - DOI - PubMed