Social Determinants of Health and Patient-Reported Outcomes Following Total Hip and Knee Arthroplasty in Veterans

Rubenstein, William J.; Harris, Alex H. S.; Hwang, Kathleen; Giori, Nicholas J.; Kuo, Alfred C.

doi:10.1016/j.arth.2020.04.095

Cited by 53 publications

(55 citation statements)

References 43 publications

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“…Ibrahim et al found that black VHA TKA patients experienced higher complication rates than whites [8]. More recently, we have found that black VHA TKA patients have lower improvements in PROMs and higher rates of revision surgery [9,10].…”

Section: Introductionmentioning

confidence: 61%

What Factors Lead to Racial Disparities in Outcomes After Total Knee Arthroplasty?

Lee

et al. 2021

J. Racial and Ethnic Health Disparities

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Total knee arthroplasty (TKA) is one of the most commonly performed, major elective surgeries in the USA. African American TKA patients on average experience worse clinical outcomes than whites, including lower improvements in patient-reported outcomes and higher rates of complications, hospital readmissions, and reoperations. The mechanisms leading to these racial health disparities are unclear, but likely involve patient, provider, healthcare system, and societal factors. Lower physical and mental health at baseline, lower social support, provider bias, lower rates of health insurance coverage, higher utilization of lower quality hospitals, and systemic racism may contribute to the inferior outcomes that African Americans experience. Limited evidence suggests that improving the quality of surgical care can offset these factors and lead to a reduction in outcome disparities.

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Section: Introductionmentioning

confidence: 61%

What Factors Lead to Racial Disparities in Outcomes After Total Knee Arthroplasty?

Lee

et al. 2021

J. Racial and Ethnic Health Disparities

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“…Similar findings were demonstrated among arthroplasty patients. 6,48,69 Black/Hispanic and publicly insured patients had significantly greater quadriceps and ROM deficits after ACLR, likely because of limitations in accessing postoperative rehabilitation for these patients. 23 Furthermore, public health insurance patients carry higher odds of requiring acute medical care within 30 days after ACLR.…”

Section: Discussionmentioning

confidence: 99%

“…4 There has been recent evidence that SDOH impact outcomes in orthopaedic surgery. 5,6 Within sports medicine, SDOH have been investigated among patients with meniscal tears, 7 rotator cuff tears, 8 and other shoulder disorders. 9 However, the effects that SDOH have on outcomes is largely unknown, particularly when it comes to treatment after anterior cruciate ligament (ACL) tears.…”

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confidence: 99%

Social Determinants of Health Influence Access to Care and Outcomes in Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Systematic Review

Ziedas

Abed

Swantek

et al. 2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Data collected included age, sex, race, ethnicity, marital status, educational attainment, income, health insurance, body mass index, TKA surgeon, TKA hospital, and medical comorbidities using the Functional Comorbidity Index (34). These variables were collected for evaluation as covariates because they have been shown in prior literature to correlate with outcomes following TKA (20)(21)(22)(23)(24)(25)(26)(27)32,(35)(36)(37)(38)(39).…”

Section: Methodsmentioning

confidence: 99%

Race Differences in Postacute Physical Therapy Utilization and Patient‐Reported Function After Total Knee Arthroplasty

Bove

Hausmann

Piva

et al. 2021

Arthritis Care & Research

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Objective This observational cohort study included patients of Black and White race and non‐Hispanic ethnicity with end‐stage knee osteoarthritis who were scheduled to receive total knee arthroplasty (TKA) surgery. Our objective was to examine whether race differences exist in the use of physical therapy (PT) across all postacute settings and to examine patient‐reported physical function following TKA. Methods We collected pre‐ and postoperative physical function data and postoperative rehabilitation data on 104 Black and White individuals undergoing TKA. Regression analyses and independent samples t‐tests were used to explore the predictive value of race on postoperative functional outcome and to compare PT utilization within each postacute setting and across all postacute rehabilitation settings. Results Total PT received was similar between White and Black participants, but significant race differences in PT utilization existed within specific settings. Race did not significantly predict function after TKA, but Black participants had slightly lower self‐reported function both before and after surgery than White participants. Conclusion This is the first study to examine both PT utilization and functional outcomes in a sample of individuals undergoing TKA, and results indicate differences in where postoperative PT is received between Black and White patients.

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Social Determinants of Health and Patient-Reported Outcomes Following Total Hip and Knee Arthroplasty in Veterans

Cited by 53 publications

References 43 publications

What Factors Lead to Racial Disparities in Outcomes After Total Knee Arthroplasty?

What Factors Lead to Racial Disparities in Outcomes After Total Knee Arthroplasty?

Social Determinants of Health Influence Access to Care and Outcomes in Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Systematic Review

Race Differences in Postacute Physical Therapy Utilization and Patient‐Reported Function After Total Knee Arthroplasty

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