Racial Disparities in Rates of Revision and use of Modern Features in Total Knee Arthroplasty, a National Registry Study.

Autor: Paisner ND; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California; Pacific Northwest University School of Health Sciences, Yakima, Washington., Upfill-Brown AM; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California., Donnelly PC; American Joint Replacement Registry, American Academy of Orthopaedic Surgery, Rosemont, Illinois., De A; American Joint Replacement Registry, American Academy of Orthopaedic Surgery, Rosemont, Illinois., Sassoon AA; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2023 Mar; Vol. 38 (3), pp. 464-469.e3. Date of Electronic Publication: 2022 Sep 24.
DOI: 10.1016/j.arth.2022.09.023
Abstrakt: Background: The purpose of our study was to investigate the association of race and ethnicity with rates of modern implant use and postoperative outcomes in total knee arthroplasty (TKA) using the American Academy of Orthopaedic Surgeons American Joint Replacement Registry.
Methods: Adult TKAs from 2012 to 2020 were queried from the American Joint Replacement Registry. A total of 1,121,457 patients were available for analysis for surgical features and 1,068,210 patients for analysis of outcomes. Mixed-effects multivariable logistic regression models were used to examine the association of race with each individual surgical feature (unicompartmental knee arthroplasty (UKA) and robotic-assisted TKA (RA-TKA)) and 30- and 90-day readmission. A proportional subdistribution hazard model was used to model the risk of revision TKA.
Results: On multivariate analyses, compared to White patients, Black (odds ratio (OR): 0.52 P < .0001), Hispanic (OR 0.75 P < .001), and Native American (OR: 0.69 P = .0011) patients had lower rates of UKA, while only Black patients had lower rates of RA-TKA (OR = 0.76 P < .001). White (hazard ratio (HR) = 0.8, P < .001), Asian (HR = 0.51, P < .001), and Hispanic-White (HR = 0.73, P = .001) patients had a lower risk of revision TKA than Black patients. Asian patients had a lower revision risk than White (HR = 0.64, P < .001) and Hispanic-White (HR = 0.69, P = .011) patients. No significant differences existed between groups for 30- or 90-day readmissions.
Conclusion: Black, Hispanic, and Native American patients had lower rates of UKA compared to White patients, while Black patients had lower rates of RA-TKA compared to White, Asian, and Hispanic patients. Black patients also had higher rates of revision TKA than other races.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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