November 14, 2005

Knee replacement tough on minority groups

By Will Boggs, MD

NEW YORK (Reuters Health) - Black and Hispanic patients
experience higher complication rates after total knee
arthroplasty, but not after hip arthroplasty, according to a
study in which doctors compared the rate of medical and
surgical complications and death rates between a group of
white, black, and Hispanic adults who had knee or hip
arthroplasty between 1996 and 2000.

More than 90 percent of the patients of each racial/ethnic
group experienced no complications within 30 days of either
type of arthroplasty, the authors report in the journal
Arthritis and Rheumatism.

However, non-infection-related complications after knee
arthroplasty were highest among blacks (3.5 percent), they

Infection-related complications after knee arthroplasty
were similar for blacks (4.7 percent) and Hispanics (5.2
percent) but lower for whites (3.6 percent).

Complication rates did not differ after hip arthroplasty
among the three groups. Also, mortality in the first 30 days
following knee arthroplasty and hip arthroplasty did not differ
by race/ethnicity, the report indicates.

"Apparently higher rates of various complications following
knee arthroplasty among minorities remain unexplained and may
represent a quality-of-care issue," Dr. Said A. Ibrahim from VA
Pittsburgh Healthcare System and University of Pittsburgh and
colleagues conclude.

"Additional quality-of-care studies should focus on
identifying the underlying reasons for these differences in
complication rates while examining other factors that
contribute to the marked racial/ethnic disparities in the
utilization of joint arthroplasty."

SOURCE: Arthritis and Rheumatism, October 2005.