Worse Pre-Op Joint Function Seen in Minority Arthroplasty Patients

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By Anthony J. Brown, MD

NEW YORK (Reuters Health) Feb 26 - Prior to arthroplasty, Hispanic and African American patients have worse hip and knee function than their Caucasian counterparts, according to findings from a study conducted in an urban setting.

"There have been only a few select studies on this topic, but the diverse urban population captured by our hospitals and the large number of patients in our joint registry makes this novel," senior researcher Dr. James D. Slover, from NYU Hospital for Joint Diseases, New York, told Reuters Health.

"At this point, we cannot explain the differences," he said. "The fact that different racial groups have different functional scores at surgery is significant because it has been shown that lower scores before surgery means lower scores after surgery, on average."

Dr. Slover's team presented the study findings this week at the American Academy of Orthopaedic Surgeons annual meeting in Las Vegas.

The researcher studied 1596 consecutive patients who underwent total hip arthroplasty and 1946 who underwent knee arthroplasty. Preoperative function was measured using the Harris Hip and Knee Society scores.

In the overall analysis, Hispanic patients and, to a lesser extent, African-American patients had worse function scores prior to both types of arthroplasty than did Caucasian patients.

Further analysis showed that Hispanic men have worse function before both knee and hip replacement than men of the other ethnic groups, while Hispanic and African-American women have worse function before hip replacement than Caucasian women.

"Whether these differences are due to different risk preferences, altered behavior of arthritis in these groups, altered access to care, less knowledge and education about arthritis and joint replacement, insurance issues or other unexplained factors needs to be explored," Dr. Slover said.

He added that his team has a study underway "examining the impact of insurance on...functional scores prior to hip and knee replacement and hope to design further studies to help elucidate the reasons for the differences we have noted.