Black women had poorer physical function before, after TKA vs white women
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During the decades before and after total knee arthroplasty, published results showed black women had significantly poorer physical function compared with white women. In addition, poorer physical function after surgery was associated with poorer preoperative physical function.
Alyson M. Cavanaugh, DPT, PhD, and colleagues used the RAND 36-item Health Survey to measure physical function scale scores and self-reported activity limitations with walking one block, walking several blocks and climbing one flight of stairs during the decade before and after TKA among 10,325 women who identified as white (n=9,528), black (n=622), or Hispanic or Latina (n=175) with Medicare fee-for-service. Over time, researchers collected a median of nine physical function measurements per participant.
Results showed lower physical function scores among black women during the decade prior to TKA compared with white women. Black women also had higher odds of experiencing difficulty walking a single block, walking multiple blocks and climbing one flight of stairs vs. white women, according to results. Throughout the decade after TKA, researchers found black women continued to have lower physical function scores.
Results showed no statistically significant differences in long-term follow-up after adjusting for preoperative physical function scores. During the pre-TKA and post-TKA periods, researchers noted similar physical function scores between Hispanic women and white women.
“The greater disability among black women with arthritis prior to knee replacement is a concern that needs to be addressed. Ensuring that black women receive appropriate and evidence-based treatments early and throughout the arthritis disease process may help to maintain function and ultimately, could result in better outcomes if total knee arthroplasty is needed,” Cavanaugh told Healio Orthopedics. “Timeliness of surgical intervention is critical, once indications for knee arthroplasty arise. Further functional declines that occur due to delayed surgical intervention may result in poorer outcomes. Future studies that evaluate the processes of care and the timing of receipt of health services are critical to knowing how the health care system could better reach and meet the needs of black women with arthritis.” – by Casey Tingle
Disclosures: Cavanaugh reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Cavanaugh AM, et al. JAMA Netw Open. 2020;doi:10.1001/jamanetworkopen.2020.4937.
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