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African American Patients Have Improved Functional Gains and Comparable Clinical Outcomes to Caucasian Patients After Total Hip and Knee Arthroplasty.
Chisari, Emanuele; Grosso, Matthew J; Nelson, Charles L; Kozaily, Elie; Parvizi, Javad; Courtney, P Maxwell.
Afiliação
  • Chisari E; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Grosso MJ; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Nelson CL; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
  • Kozaily E; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Parvizi J; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Courtney PM; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
J Arthroplasty ; 36(1): 88-92, 2021 01.
Article em En | MEDLINE | ID: mdl-32771290
BACKGROUND: With the increasing popularity of alternative payment models, minorities who use more postacute care resources may face difficulties with access to quality total hip arthroplasty (THA) and total knee arthroplasty (TKA) care. The purpose of this study is to compare differences in perioperative complications and functional outcomes between African American and Caucasian patients undergoing THA and TKA. METHODS: We reviewed a consecutive series of all primary THA and TKA patients at our institution from 2015 to 2018. Demographics, comorbidities, 90-day complications, readmissions, Veterans Rand 12-Item Health Survey (VR-12), Hip disability Osteoarthritis Outcome Score (HOOS), and Knee injury and Osteoarthritis Outcome Scores (KOOS) were compared between African American and Caucasian patients. A multivariate analysis was performed to control for confounding variables. RESULTS: Of the 5284 patients included in the study, 1041 were African American (24.5%). Although African American patients had lower preoperative HOOS/KOOS (33.5 vs 45.1, P < .001) and mental VR-12 scores (37.8 vs 51.5, P < .001) compared with Caucasian patients, there was no clinical difference at 1 year in HOOS/KOOS (50.2 vs 50.4), mental VR-12 (55.0 vs 52.6), or physical VR-12 scores (39.5 vs 39.8). When controlling for demographics and medical comorbidities, African American race was associated with increased rehabilitation facility discharge (odds ratio, 1.69; P < .001) but no difference in readmissions or complications. CONCLUSION: Although African American patients had lower preoperative functional scores, they made improved postoperative gains when compared with Caucasian patients. Although there was no difference in postoperative complications, further studies should assess social causes for the increase in rehabilitation utilization rates in minority patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteoartrite do Quadril / Artroplastia de Quadril / Artroplastia do Joelho Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteoartrite do Quadril / Artroplastia de Quadril / Artroplastia do Joelho Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos