Dr. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, URL, Novartis, Allergan, and Savient, and (more than $10,000 each) from Ardea and Takeda, and has received investigator-initiated research grants from Savient, Takeda, Allergan, Wyeth, and Amgen.
Patient race and surgical outcomes after total knee arthroplasty: An analysis of a large regional database†
Article first published online: 26 FEB 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 3, pages 414–420, March 2013
How to Cite
Blum, M. A., Singh, J. A., Lee, G.-C., Richardson, D., Chen, W. and Ibrahim, S. A. (2013), Patient race and surgical outcomes after total knee arthroplasty: An analysis of a large regional database. Arthritis Care Res, 65: 414–420. doi: 10.1002/acr.21834
The views expressed herein are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.
- Issue published online: 21 FEB 2013
- Article first published online: 26 FEB 2013
- Accepted manuscript online: 29 AUG 2012 03:05PM EST
- Manuscript Accepted: 13 AUG 2012
- Manuscript Received: 16 NOV 2011
- NIH. Grant Number: Clinical Translational Science Award 1-KL2-RR-024151-01
- NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: 1-K24-AR-055259-06
- Zimmer and Smith & Nephew
To examine racial differences in surgical complications, mortality, and revision rates after total knee arthroplasty.
We studied patients undergoing primary total knee arthroplasty using 2001–2007 Pennsylvania Health Care Cost Containment Council data. We conducted bivariate analyses to assess the risk of complications such as myocardial infarction, venous thromboembolism, wound infections, and failure of prosthesis, as well as 30-day and 1-year overall mortality after elective total knee arthroplasty, between racial groups. We estimated Kaplan-Meier 1- and 5-year surgical revision rates, and fit multivariable Cox proportional hazards models to compare surgical revision by race, incorporating 5 years of followup. We adjusted for patient age, sex, length of hospital stay, surgical risk of death, type of health insurance, hospital surgical volume, and hospital teaching status.
In unadjusted analyses, there were no significant differences by racial group for either overall 30-day or in-hospital complication rates, or 30-day and 1-year mortality rates. Adjusted Cox models incorporating 5 years of followup showed an increased risk of revisions for African American patients (hazard ratio [HR] 1.39, 95% confidence interval [95% CI] 1.08–1.80), younger patients (HR 2.30, 95% CI 1.96–2.69), and lower risk for female patients (HR 0.81, 95% CI 0.71–0.92).
In this sample of patients who underwent knee arthroplasty, we found no significant racial differences in major complication rates or mortality. However, African American patients, younger patients, and male patients all had significantly higher rates of revision based on 5 years of followup.