Racial Disparities in Total Knee Replacement Failure As Related to Poverty.
Black or African American
/ statistics & numerical data
Aged
Arthroplasty, Replacement, Knee
/ adverse effects
Female
Health Status Disparities
Humans
Male
Middle Aged
New York
/ epidemiology
Postoperative Complications
/ epidemiology
Poverty
/ ethnology
Prospective Studies
Quality of Life
Registries
Risk Factors
Treatment Failure
White People
/ statistics & numerical data
Journal
Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
23
12
2018
accepted:
09
07
2019
pubmed:
17
7
2019
medline:
11
4
2020
entrez:
17
7
2019
Statut:
ppublish
Résumé
To determine whether racial disparities in total knee replacement (TKR) failure are explained by poverty. Black and white New York state residents, enrolled in a prospective single-institution TKR registry January 1, 2008 to February 6, 2012, who underwent primary unilateral TKR (n = 4,062) were linked to the New York Statewide Planning and Research Cooperative System database (January 1, 2008 to December 31, 2014) to capture revisions performed at outside institutions. Patients were linked by geocoded addresses to residential census tracts. Multivariable Cox regression was used to assess predictors of TKR revision. Multivariable logistic regression was used to analyze predictors of TKR failure, defined as TKR revision in New York state ≤2 years after surgery, or as Hospital for Special Surgery (HSS) TKR quality of life score "not improved" or "worsened" 2 years after surgery. The mean ± SD age was 68.4 ± 10 years, 64% of patients were female, 8% lived in census tracts with >20% of the population under the poverty line, and 9% were black. Median follow-up time was 5.3 years. A total of 3% of patients (122 of 4,062) required revision a median 454 days (interquartile range 215-829) after surgery. TKR revision risk was higher in blacks than whites, with a hazard ratio of 1.69 (95% confidence interval 1.01-2.81), but in multivariable analysis, only younger age, male sex, and constrained prosthesis were predictors of TKR revision. TKR failure occurred in 200 of 2,832 cases (7%) with 2-year surveys. Risk factors for TKR failure were non-osteoarthritis TKR indication, low surgeon volume, and low HSS Expectations Survey score, but not black race. Community poverty was not associated with TKR revision or failure. There was a trend toward higher TKR revision risk in blacks, but poverty did not modify the relationship between race and TKR revision or failure.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1488-1494Subventions
Organisme : Hospital for Special Surgery Complex Joint Reconstruction Center
Pays : International
Organisme : AHRQ HHS
ID : U18 HS016075
Pays : United States
Informations de copyright
© 2019, American College of Rheumatology.
Références
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;98:2103-8.
Roche M, Law TY, Sultan AA, Umpierrez E, Khlopas A, Rosas S, et al. Racial disparities in revision total knee arthroplasty: analysis of 125,901 patients in national US private payer database. J Racial Ethn Health Disparities 2019;6:101-9.
Dy CJ, Marx RG, Bozic KJ, Pan TJ, Padgett DE, Lyman S. Risk factors for revision within 10 years of total knee arthroplasty. Clin Orthop Relat Res 2014;472:1198-207.
Blum MA, Singh JA, Lee GC, Richardson D, Chen W, Ibrahim SA. Patient race and surgical outcomes after total knee arthroplasty: an analysis of a large regional database. Arthritis Care Res (Hoboken) 2013;65:414-20.
Bolognesi MP, Greiner MA, Attarian DE, Watters TS, Wellman SS, Curtis LH, et al. Unicompartmental knee arthroplasty and total knee arthroplasty among Medicare beneficiaries, 2000 to 2009. J Bone Joint Surg Am 2013;95:e174.
Namba RS, Cafri G, Khatod M, Inacio MC, Brox TW, Paxton EW. Risk factors for total knee arthroplasty aseptic revision. J Arthroplasty 2013;28:122-7.
Goodman SM, Mandl LA, Parks ML, Zhang M, McHugh KR, Lee Y, et al. Disparities in TKA outcomes: census tract data show interactions between race and poverty. Clin Orthop Relat Res 2016;474:1986-95.
Goodman SM, Mandl LA, Mehta B, Navarro-Millan I, Russell LA, Parks ML, et al. Does education level mitigate the effect of poverty on total knee arthroplasty outcomes? Arthritis Care Res (Hoboken) 2018;70:884-91.
Roos EM, Toksvig-Larsen S. Knee injury and osteoarthritis outcome score (KOOS): validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 2003;1:17.
Bellamy N. Outcome measurement in osteoarthritis clinical trials. J Rheumatol Suppl 1995;43:49-51.
Nilsdotter AK, Toksvig-Larsen S, Roos EM. A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthritis Cartilage 2009;17:601-6.
Mancuso CA, Sculco TP, Wickiewicz TL, Jones EC, Robbins L, Warren RF, et al. Patients’ expectations of knee surgery. J Bone Joint Surg Am 2001;83:1005-12.
Subramanian SV, Chen JT, Rehkopf DH, Waterman PD, Krieger N. Comparing individual- and area-based socioeconomic measures for the surveillance of health disparities: a multilevel analysis of Massachusetts births, 1989-1991. Am J Epidemiol 2006;164:823-34.
Subramanian SV, Chen JT, Rehkopf DH, Waterman PD, Krieger N. Racial disparities in context: a multilevel analysis of neighborhood variations in poverty and excess mortality among black populations in Massachusetts. Am J Public Health 2005;95:260-5.
Krieger N, Chen JT, Waterman PD, Rehkopf DH, Subramanian SV. Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures: the public health disparities geocoding project. Am J Public Health 2003;93:1655-71.
Lyman S, Lee Y, Franklin PD, Li W, Cross MB, Padgett DE. Validation of the KOOS, JR: a short-form knee arthroplasty outcomes survey. Clin Orthop Relat Res 2016;474:1461-71.
Jeschke E, Citak M, Günster C, Matthias Halder A, Heller K, Malzahn J, et al. Are TKAs performed in high-volume hospitals less likely to undergo revision than TKAs performed in low-volume hospitals? Clin Orthop Relat Res 2017;475:2669-74.
Wilson S, Marx RG, Pan T, Lyman S. Meaningful thresholds for the volume-outcome relationship in total knee arthroplasty. J Bone Joint Surg Am 2016;98:1683-90.
Badawy M, Espehaug B, Indrekvam K, Engesaeter LB, Havelin LI, Furnes O. Influence of hospital volume on revision rate after total knee arthroplasty with cement. J Bone Joint Surg Am 2013;95:e131.
Cai X, Cram P, Vaughan-Sarrazin M. Are African American patients more likely to receive a total knee arthroplasty in a low-quality hospital? Clin Orthop Relat Res 2012;470:1185-93.
FitzGerald JD, Soohoo NF, Losina E, Katz JN. Potential impact on patient residence to hospital travel distance and access to care under a policy of preferential referral to high-volume knee replacement hospitals. Arthritis Care Res (Hoboken) 2012;64:890-7.
Piccolo RS, Duncan DT, Pearce N, McKinlay JB. The role of neighborhood characteristics in racial/ethnic disparities in type 2 diabetes: results from the Boston area community health (BACH) survey. Soc Sci Med 2015;130:79-90.
Bozic KJ, Lau E, Ong K, Chan V, Kurtz S, Vail TP, et al. Risk factors for early revision after primary TKA in Medicare patients. Clin Orthop Relat Res 2014;472:232-7.
Pitta M, Esposito CI, Li Z, Lee Y, Wright TM, Padgett DE. Failure after modern total knee arthroplasty: a prospective study of 18,065 knees. J Arthroplasty 2018;33:407-14.
Vertullo CJ, Lewis PL, Lorimer M, Graves SE. The effect on long-term survivorship of surgeon preference for posterior-stabilized or minimally stabilized total knee replacement: an analysis of 63,416 prostheses from the Australian Orthopaedic Association National Joint Replacement registry. J Bone Joint Surg Am 2017;99:1129-39.
Liddle AD, Pandit H, Judge A, Murray DW. Effect of surgical caseload on revision rate following total and unicompartmental knee replacement. J Bone Joint Surg Am 2016;98:1-8.
Bottomley N, Jones LD, Rout R, Alvand A, Rombach I, Evans T, et al. A survival analysis of 1084 knees of the Oxford unicompartmental knee arthroplasty: a comparison between consultant and trainee surgeons. Bone Joint J 2016;98-B:22-7.
Bayliss LE, Culliford D, Monk AP, Glyn-Jones S, Prieto-Alhambra D, Judge A, et al. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Lancet 2017;389:1424-30.
Julin J, Jämsen E, Puolakka T, Konttinen YT, Moilanen T. Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis: a follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty register. Acta Orthop 2010;81:413-9.
Meehan JP, Danielsen B, Kim SH, Jamali AA, White RH. Younger age is associated with a higher risk of early periprosthetic joint infection and aseptic mechanical failure after total knee arthroplasty. J Bone Joint Surg Am 2014;96:529-35.
Stambough JB, Clohisy JC, Barrack RL, Nunley RM, Keeney JA. Increased risk of failure following revision total knee replacement in patients aged 55 years and younger. Bone Joint J 2014;96-B:1657-62.
Singh JA, Kwoh CK, Richardson D, Chen W, Ibrahim SA. Sex and surgical outcomes and mortality after primary total knee arthroplasty: a risk-adjusted analysis. Arthritis Care Res (Hoboken) 2013;65:1095-102.
Jain D, Nguyen LL, Bendich I, Nguyen LL, Lewis CG, Huddleston JI, et al. Higher patient expectations predict higher patient-reported outcomes, but not satisfaction, in total knee arthroplasty patients: a prospective multicenter study. J Arthroplasty 2017;32:S166-70.
Ibrahim SA, Siminoff LA, Burant CJ, Kwoh CK. Differences in expectations of outcome mediate African American/white patient differences in “willingness” to consider joint replacement. Arthritis Rheum 2002;46:2429-35.
Hadden KB, Prince LY, Bushmiaer MK, Watson JC, Barnes CL. Health literacy and surgery expectations in total hip and knee arthroplasty patients. Patient Educ Couns 2018;101:1823-7.
Mantwill S, Monestel-Umaña S, Schulz PJ. The relationship between health literacy and health disparities: a systematic review. PLoS One 2015;10:e0145455.
Singh JA, Lu X, Rosenthal GE, Ibrahim S, Cram P. Racial disparities in knee and hip total joint arthroplasty: an 18-year analysis of national Medicare data. Ann Rheum Dis 2014;73:2107-15.