Racial, ethnic disparities exist in TJA utilization, postoperative outcomes
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According to published results, several racial and ethnic disparities in utilization rates and postoperative outcomes exist among patients who undergo total joint arthroplasty.
In August 2021, researchers performed a systematic review and meta-analysis of PubMed, Scopus, CINAHL and SPORTDiscus databases to examine inequalities in TJA care between Black, Hispanic, Asian, American Indian-Alaska Native, Pacific Islander and white patients. The researchers identified 63 studies which analyzed TJA utilization, complications, mortality, length of stay (LOS), discharge disposition, readmission and reoperation in these patients.
After both total hip arthroplasty and total knee arthroplasty, Black patients exhibited higher rates of 30-day complications, 30-day mortality, prolonged LOS, nonhome discharges and 30-day readmissions compared with white patients. Black patients also were less likely to undergo TJA compared with white patients. Hispanic patients also had increased rates of complications, prolonged LOS and nonhome discharges compared with white patients. Asian patients had longer LOS compared with white patients but fewer readmissions, the researchers noted.
While infrequently reported, findings for American Indian-Alaska Native and Pacific Islander patients were similarly inequitable, according to the study.
“Considering the potential to influence patient preferences regarding treatment, the patient-provider relationship and overall health outcomes, these findings warrant consideration by patients, orthopedic surgeons and policymakers alike to focus efforts toward understanding and addressing racial disparities in TJA,” the researchers wrote.
“While studies demonstrating reductions in racial inequality in TJA care indicate progress is possible, further focused efforts are needed to better understand and address the root causes of racial disparities to ensure optimal care for all,” they concluded.
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Rudisill SS, et al. J Arthroplasty. 2022;doi:10.1016/j.arth.2022.08.006.
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