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. 2022 Feb 7;10(2):23259671211069944.
doi: 10.1177/23259671211069944. eCollection 2022 Feb.

Evaluation of Differences Between Non-Hispanic White and African American Patients With Sports Medicine-Related Hip Disabilities

Marsalis Brown  1 , Thiran Udawatta  2 , Lance Flesch  2 , Gregory J Strnad  3   4 , Isaac Briskin  3   4 , Morgan Jones  3   5 , Scott Kaar  2 , James T Rosneck  3   5 , Lutul D Farrow  3   5
Affiliations

Evaluation of Differences Between Non-Hispanic White and African American Patients With Sports Medicine-Related Hip Disabilities

Marsalis Brown et al. Orthop J Sports Med. .

Abstract

Background: Racial disparities within the field of orthopaedics are well-documented in the spinal surgery, knee arthroplasty, and hip arthroplasty literature. Not much is known about racial differences in patients with sports medicine-related hip disabilities.

Purpose: To investigate whether differences exist between African American and non-Hispanic White (White) patients evaluated for hip disabilities.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: We performed a multicenter retrospective cohort study of 905 patients who were evaluated over a 1-year period for hip-related orthopaedic concerns. Patient demographic data, disability characteristics, and hip radiographic findings were obtained from electronic medical records. We also obtained data on whether patients were offered physical therapy, magnetic resonance imaging (MRI), and/or surgery. Comparisons by race and insurance status were evaluated using univariate and multivariate analyses.

Results: African Americans comprised a significantly lower proportion of the patients evaluated for hip-related disabilities compared with Whites (6.5% vs 93.5%; P < .001). A significantly smaller proportion of African Americans with hip disabilities was recommended for surgery than White patients (35.6% vs 54.6%; P = .007). Cam deformities were more common in White vs African American patients (39.7% vs 23.7%; P = .021), as were labral tears (54.1% vs 35.6%; P = .009). Logistic regression demonstrated that neither race nor insurance status were significant determinants in surgery recommendations. Conversely, race was a determinant of whether an MRI was performed, as White patients were 2.74 times more likely to have this procedure. There were no differences with respect to obtaining an MRI between private and Medicaid insurance.

Conclusion: Compared with White patients, there were differences in both the proportion of African Americans evaluated for hip-related disabilities and the proportion receiving a surgery recommendation. African Americans with sports medicine-related hip issues were also less likely to obtain an MRI. With regard to observed pathology, African American patients were less likely to have cam deformities and labral tears than White patients.

Keywords: femoroacetabular impingement; hip; hip arthroscopy; racial disparities; sports medicine.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: M.B. has received education payments from Rock Medical. T.U. has received education payments from Elite Orthopedics. S.K. has received education payments from Arthrex and Elite Orthopedics, consulting fees from DePuy/Medical Device Business Services, and nonconsulting fees from Arthrex. J.T.R. has received nonconsulting fees from Smith & Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flowchart of patient enrollment in study.
Figure 2.
Figure 2.
Modeling probability of surgery recommendation. MRI, magnetic resonance imaging; PT, physical therapy.
Figure 3.
Figure 3.
Modeling probability of having an MRI performed. MRI, magnetic resonance imaging; PT, physical therapy.
See this image and copyright information in PMC

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