Sex and Race Characteristics in Patients Undergoing Hip and Knee Arthroplasty in an Urban Setting

https://doi.org/10.1016/j.arth.2009.03.002Get rights and content

Abstract

The purpose of this study was to examine the relationship between sex, race, and preoperative function in a large diverse patient population undergoing hip and knee arthroplasty. An observational study was conducted on 3542 consecutive primary unilateral total hip and knee arthroplasties. Harris Hip and Knee Society Scores were used to quantify preoperative function. The results demonstrate lower function, with average Harris Hip Scores that were 4.9 (P < .0001) and 8.77 (P < .001) and average Knee Society Scores that were 6.03 (P < .06) and 12.8 (P < .001) points lower in African American and Hispanic patients than white patients for the population, respectively. This study demonstrates that Hispanic and African American patients have worse preoperative hip and knee function before arthroplasty than white patients. Future efforts to elucidate the reasons for this decreased function as well as efforts to rectify any disparities should target these patient populations.

Section snippets

Methods

An observational study was conducted on 3542 consecutive primary unilateral total hip (n = 1596) and knee (n = 1946) arthroplasties performed at the NYU Hospital for Joint Diseases, New York, New York, between January 1997 and July 2006. Physical examinations and standardized questionnaires were administered to patients before their surgery. The data from these comprised the functional components of the Harris Hip Score and the Knee Society Score, which were used to quantify functional ability

Results

Harris Hip Scores were 4.9 (P < .0001) and 8.77 (P < .001) points lower in African American and Hispanic patients than white patients for the population, respectively. Similar findings were found in preoperative total knee arthroplasty patients with 6.03 (P < .06) and 12.8 (P < .001) lower average Knee Society Scores in African American and Hispanic patients than white patients for the population, respectively. For men, hip and knee scores were worse for Hispanics and African Americans relative

Discussion

Although, several studies have demonstrated worse function for women before joint arthroplasty 5, 6, this is the first to examine large groups of men and women in different racial groups. This study demonstrated several key findings in the urban population. First, African American and Hispanic patients presented with lower function scores than whites before hip and knee arthroplasty surgery, with Hispanics having the lowest scores of the 3 groups. Second, women demonstrated lower preoperative

Conclusion

This study demonstrates that Hispanic and African American patients have worse preoperative hip and knee function before arthroplasty than white patients. In particular, Hispanic men had worse function before hip and knee arthroplasty than both African American and white men, and Hispanic and African American women had significantly worse function before hip arthroplasty than white women. This is important because studies have demonstrated that lower preoperative function results in lower

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    Our registry has been supported by educational grants from Smith and Nephew in the past.

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