Ethnic and Gender Differences in the Functional Disparities after Primary Total Knee Arthroplasty
Open Access
- 1 December 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics & Related Research
- Vol. 468 (12), 3355-3361
- https://doi.org/10.1007/s11999-010-1461-y
Abstract
The benefits of TKA have been well documented. Whether these benefits apply equally across gender and ethnic groups is unclear. Given the underuse of TKA among certain demographic groups, it is important to understand whether gender or ethnicity influence pain and function after TKA. We determined (1) the influence of race, gender, and body mass index (BMI) on primary TKA functional scores and ROM before gender-specific implants; and (2) whether comorbidities influenced ROM and functional scores. We reviewed all 202 patients who underwent primary TKAs in 2004. We contacted 185 of the 202 patients, including 90 African-Americans, 87 Caucasians, four Asians, and four Hispanics (55 men, 130 women). Their average age was 66 years, and average BMI was 34.4 (range, 20–55). Knee Society scores (KSS) and ROM, patient demographics, and the Charlson Comorbidity Index (CCI) were recorded. Minimum followup was 24 months (average, 29.1 months; range, 24–60.3 months). African-Americans had longer delays to presentation, higher BMI, and worse 2-year KSS. Women (all races) had higher BMI and worse preoperative flexion/arc ROM. African-American women had worse final ROM and had similar final gains in ROM (postoperative minus preoperative ROM) after controlling for confounders. Gender and race affected functional KSS and ROM variables. The worse results experienced by African-American women may be attributable to a longer delay to presentation. However, the scores and motion were high for all subgroups, and underuse of TKA in women and African-Americans cannot be justified based on a perception of lesser functional gains. Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.Keywords
This publication has 35 references indexed in Scilit:
- Fear in Arthroplasty Surgery: The Role of RaceClinical Orthopaedics & Related Research, 2010
- Patients' gender affected physicians' clinical decisions when presented with standardized patients but not for matching paper patientsJournal of Clinical Epidemiology, 2009
- Racial differences in self-reported pain and function among individuals with radiographic hip and knee osteoarthritis: the Johnston County Osteoarthritis ProjectOsteoarthritis and Cartilage, 2009
- Reduced rates of primary joint replacement for osteoarthritis in Italian and Greek migrants to Australia: the Melbourne Collaborative Cohort StudyArthritis Research & Therapy, 2009
- No Difference in Gender-specific Hip Replacement OutcomesClinical Orthopaedics & Related Research, 2009
- The Female Knee: Anatomic Variations and the Female-specific Total Knee DesignClinical Orthopaedics & Related Research, 2008
- The John Insall Award: Gender-specific Total Knee Replacement: Prospectively Collected Clinical OutcomesClinical Orthopaedics & Related Research, 2008
- Age and Racial/Ethnic Disparities in Arthritis-Related Hip and Knee SurgeriesMedical Care, 2008
- Ethnic differences in preoperative function of patients undergoing total knee arthroplastyInternational Orthopaedics, 2006
- Brief report: Gender and total knee/hip arthroplasty utilization rate in the VA systemJournal of General Internal Medicine, 2006