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Socioeconomic status has little impact on patients' outcomes following TKR

Although most patients with lower incomes had more pain preoperatively, postoperative scores were comparable to many wealthier patients.

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GLASGOW, Scotland — Patients from lower socioeconomic groups tend to experience more pain and disability prior to total knee replacement compared to their wealthier counterparts. But lower income patients tend to compensate and achieve comparable postoperative outcomes, according to a recent multicenter study presented here.

E.A. Lingard, FRCS, and colleagues in Newcastle, England, conducted a prospective, observational study of 974 patients undergoing TKR at 13 centers in the United Kingdom, the United States, Canada and Australia.

Lingard presented the results at the British Orthopaedic Association Annual Congress.

Researchers had collected data on patients' demographics, socioeconomic status, height, weight and comorbid conditions as well as WOMAC and SF-36 scores, Lingard said. Such data were recorded preoperatively and at 3 months, 12 months and 2 years postop.

"The majority of the patients came from the United Kingdom, and these patients were significantly older than those from the other countries," she said. Practically all of the patients were Caucasian. One patient group from New York included 50% African-American, 25% Hispanic and 25% Caucasian patients, she said.

"We saw that patients who had a lot of income woes preoperatively had worse function initially," she said.

However, patients' level of income and educational status did not appear to affect the final TKR outcome. Lower income patients demonstrated improved WOMAC and SF-36 scores, and their improvement was often greater than that achieved by their wealthier counterparts, she said.

For more information:

• Davis ET, Lingard EA, Schemitsch EH, Waddell JP. The effects of socioeconomic status on patients' outcome following total knee arthroplasty. Presented at the British Orthopaedic Association Annual Congress. Sept. 27-29, 2006. Glasgow, Scotland.