2009 Annual Meeting Poster Presentations
Gender and Race Characteristics in Patients Undergoing Hip and Knee Replacement in an Urban Setting
Poster Presentation Number: P088 Location: Venetian/Sands EXPO Hall DAdult Reconstruction Hip
Michael Walsh, PhD New York NYJoseph D Zuckerman, MD New York NY
James D Slover, MD New York NY
This study demonstrates that Hispanic and African American patients have worse pre-operative hip and knee function prior to arthroplasty than Caucasian patients.
The potential for gender and racial disparities in the practice of orthopaedic surgery remains an issue of primary concern for our profession. The purpose of this study was to examine the relationship between gender, race and pre-operative function in a large, diverse patient population undergoing hip and knee replacement.
An observational study was conducted on 3542 consecutive primary unilateral total hip (n=1596) and knee (n=1946) arthroplasties. Harris Hip and Knee Society scores were used to quantify pre-operative function. Student's t-tests were used to compare crude sex differences within each ethnic group. One-way ANOVA was used to assess differences between the different ethnic groups using Bonferroni adjusted multiple comparisons. Finally, multiple linear regression was used to simultaneously adjust for the potential confounding of age while also assessing effect modification of ethnicity by sex.
The results demonstrate lower function, with an average Harris Hip Scores that was 4.9 (p<0.0001), and 8.77 (P<0.001) points lower in African-American, and Hispanic patients than Caucasian patients for the population, respectively. Similar findings were found in pre-operative total knee replacement patients with 6.03 (P<0.06), and 12.8 (P<0.001) lower average Knee Society Scores in African-American, and Hispanic patients than Caucasian patients for the population, respectively. Statistically significantly worse pre-operative hip function was found in Hispanic men and African-American, and Hispanic women, with an average Harris Hip Score that is 8.8 (p<0.001), 5.22 (P<0.003), and 8.32(P<0.001) points lower than Caucasians for these groups. Hispanic men also had statistically significantly worse pre-operative knee function than both African-American and Caucasian men with average Knee Society Scores that were 18.92 (P<0.009) and 23.53 (P<0.006) points lower than these groups.
This study demonstrates that Hispanic and African American patients have worse pre-operative hip and knee function prior to arthroplasty than Caucasian patients. In particular, Hispanic men had worse function prior to knee and hip replacement than both African-American and Caucasian men, and Hispanic and African-American women had significantly worse function prior to hip replacement than Caucasian women. Future efforts to elucidate the reasons for this decreased function as well as efforts to rectify any disparities should target these patient populations.
A · to the left of the title indicates the FDA has not cleared the drug or device for the described purpose.
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Poster presentations are designed to provide registrants with an in-depth learning experience. New investigations, methods and innovative research are featured in the Poster Exhibits.
The presenter will be available at the exhibit from 11:30 AM to 12:30 PM Wednesday through Friday for discussion.
An alphabetical listing of disclosures will be available at a later time.
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