Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
Aged
Arthroplasty, Replacement, Knee
/ adverse effects
Biomechanical Phenomena
Disability Evaluation
Emigrants and Immigrants
Female
Hospitals, High-Volume
Humans
Knee Joint
/ physiopathology
Male
Middle Aged
Pain Measurement
Recovery of Function
Registries
Residence Characteristics
Retrospective Studies
Social Determinants of Health
Time Factors
Treatment Outcome
United States
/ epidemiology
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
09 Feb 2019
09 Feb 2019
Historique:
received:
30
04
2018
accepted:
31
01
2019
entrez:
11
2
2019
pubmed:
11
2
2019
medline:
31
7
2019
Statut:
epublish
Résumé
Community characteristics such as poverty affect total knee arthroplasty (TKA) outcomes. However, it is unknown whether other community factors such as immigrant proportion (IP) also affect outcomes. Our objective was to determine the association of neighborhood IP on preoperative (pre-op) and 2-year postoperative (post-op) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function after elective TKA. Patients in a high volume institutional TKA registry between May 2007 and February 2011 were retrospectively analyzed. Demographics, pre-op and 2-year post-op WOMAC pain and function scores, and geocodable addresses were obtained. Patient-level variables were linked to US Census Bureau census tract data. The effect of patient and neighborhood-level factors on WOMAC scores were analyzed using linear mixed effects models. 3898 TKA patients were analyzed. Pre-op and 2-year post-op WOMAC pain and function scores were between 2.75-4.88 WOMAC points worse in neighborhoods with a high IP (≥ 40%) compared to low IP (< 10%). In multivariable analyses, these differences were not statistically significant. Women had worse pre-op and 2-year post-op WOMAC scores (all p ≤ 0.04), but this difference was not influenced by neighborhood IP (all p Patients living in high (≥40%) IP neighborhoods do not have worse pre-op or 2-year post-op pain and function outcomes after TKA compared to those living in low (< 10%) IP neighborhoods. Although sex differences favoring males are notable, these differences are not associated with IP. High neighborhood IP do not appear to affect outcomes after TKA.
Sections du résumé
BACKGROUND
BACKGROUND
Community characteristics such as poverty affect total knee arthroplasty (TKA) outcomes. However, it is unknown whether other community factors such as immigrant proportion (IP) also affect outcomes. Our objective was to determine the association of neighborhood IP on preoperative (pre-op) and 2-year postoperative (post-op) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function after elective TKA.
METHODS
METHODS
Patients in a high volume institutional TKA registry between May 2007 and February 2011 were retrospectively analyzed. Demographics, pre-op and 2-year post-op WOMAC pain and function scores, and geocodable addresses were obtained. Patient-level variables were linked to US Census Bureau census tract data. The effect of patient and neighborhood-level factors on WOMAC scores were analyzed using linear mixed effects models.
RESULTS
RESULTS
3898 TKA patients were analyzed. Pre-op and 2-year post-op WOMAC pain and function scores were between 2.75-4.88 WOMAC points worse in neighborhoods with a high IP (≥ 40%) compared to low IP (< 10%). In multivariable analyses, these differences were not statistically significant. Women had worse pre-op and 2-year post-op WOMAC scores (all p ≤ 0.04), but this difference was not influenced by neighborhood IP (all p
CONCLUSIONS
CONCLUSIONS
Patients living in high (≥40%) IP neighborhoods do not have worse pre-op or 2-year post-op pain and function outcomes after TKA compared to those living in low (< 10%) IP neighborhoods. Although sex differences favoring males are notable, these differences are not associated with IP. High neighborhood IP do not appear to affect outcomes after TKA.
Identifiants
pubmed: 30738438
doi: 10.1186/s12891-019-2446-y
pii: 10.1186/s12891-019-2446-y
pmc: PMC6368727
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Pagination
67Subventions
Organisme : NIAMS NIH HHS
ID : K23 AR068449
Pays : United States
Organisme : National Center for Advancing Translational Sciences
ID : UL1TR000457
Organisme : Agency for Healthcare Research and Quality
ID : U18HS016075
Références
J Bone Joint Surg Am. 2001 Jul;83-A(7):1005-12
pubmed: 11451969
Am J Public Health. 2003 Oct;93(10):1655-71
pubmed: 14534218
Arthritis Rheum. 2006 Jan;54(1):226-9
pubmed: 16385518
J Urban Health. 2006 May;83(3):355-61
pubmed: 16739037
Arch Intern Med. 2007 Jan 22;167(2):182-7
pubmed: 17242320
Arthritis Rheum. 2007 Feb;56(2):568-74
pubmed: 17265491
J Bone Joint Surg Am. 2007 Apr;89(4):780-5
pubmed: 17403800
Demography. 2008 Feb;45(1):79-94
pubmed: 18390292
J Immigr Minor Health. 2011 Feb;13(1):9-14
pubmed: 20232147
Clin Geriatr Med. 2010 Aug;26(3):355-69
pubmed: 20699159
J Intern Med. 2011 Aug;270(2):147-57
pubmed: 21114692
Ann Rheum Dis. 2011 May;70(5):785-91
pubmed: 21288960
N Engl J Med. 1990 Sep 20;323(12):801-7
pubmed: 2136367
N Engl J Med. 1990 Sep 13;323(11):725-31
pubmed: 2201916
J Bone Joint Surg Am. 2012 Feb 1;94(3):201-7
pubmed: 22298051
J Rheumatol. 2013 May;40(5):611-6
pubmed: 23547208
Ann Rheum Dis. 2014 Dec;73(12):2107-15
pubmed: 24047869
Acta Orthop. 2014 Jun;85(3):221-8
pubmed: 24803309
Am J Ophthalmol. 2014 Oct;158(4):800-807.e5
pubmed: 25034114
Matern Child Health J. 2015 Jun;19(6):1354-63
pubmed: 25430802
Glob Health Action. 2015 Sep 09;8:27591
pubmed: 26361347
Biomed Res Int. 2015;2015:460181
pubmed: 26504808
J Rheumatol. 2016 Apr;43(4):765-70
pubmed: 26834217
Acta Orthop. 2016 Jun;87(3):218-24
pubmed: 26848766
J Arthroplasty. 2016 Sep;31(9):1873-1877.e2
pubmed: 27026646
BMC Pregnancy Childbirth. 2016 Apr 26;16:86
pubmed: 27113930
Clin Orthop Relat Res. 2016 Sep;474(9):1986-95
pubmed: 27278675
Glob Heart. 2016 Sep;11(3):353-363
pubmed: 27741982
J Bone Joint Surg Am. 2016 Oct 19;98(20):1683-1690
pubmed: 27869618
Arthritis Care Res (Hoboken). 2018 Jun;70(6):884-891
pubmed: 29164795
J Rheumatol. 1988 Dec;15(12):1833-40
pubmed: 3068365
Am J Public Health. 1994 Mar;84(3):351-8
pubmed: 8129049