ArticleAnnals of the rheumatic diseases2004
Inequalities in access to knee joint replacements for people in need.
Article in Annals of the rheumatic diseases, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- Determinants of demand for total hip and knee arthroplasty: a systematic literature review.BMC health services research · 2012Pooled it
- Trial
- A single group follow-up study of non-surgical patients seen by physiotherapists working in expanded roles in orthopaedic departments: recall of recommendations, change in exercise and self-efficacy.BMC research notes · 2012Trial
- Association of neighborhood-level disadvantage beyond individual sociodemographic factors in patients with or at risk of knee osteoarthritis.BMC musculoskeletal disorders · 2024Article
- Private health insurance in the United States and Sweden: A comparative review.Health science reports · 2024Article
- The relation between socioeconomic status and patient symptoms before and one year after lower extremity arthroplasty.Journal of orthopaedics · 2023Article
- The Effect of Age, Sex, Area Deprivation, and Living Arrangements on Total Knee Replacement Outcomes: A Study Involving the United Kingdom National Joint Registry Dataset.JB & JS open access · 2018Article
- The rate of joint replacement in osteoarthritis depends on the patient's socioeconomic status.Acta orthopaedica · 2016Article
- Has socioeconomic equity increased in somatic specialist care: a register-based cohort study from Finland in 1995-2010.BMC health services research · 2014Article
- Article
- Disability for daily living is a predictor for joint replacement in patients with end-stage knee osteoarthritis.Journal of bone and mineral metabolism · 2014Article
- The contribution of health policy and care to income differences in life expectancy--a register based cohort study.BMC public health · 2013Article
- Smoking and primary total hip or knee replacement due to osteoarthritis in 54,288 elderly men and women.BMC musculoskeletal disorders · 2013Article
- Surgery or consultation: a population-based cohort study of use of orthopaedic surgeon services.PloS one · 2013Article
- The influence of insurance status on access to and utilization of a tertiary hand surgery referral center.The Journal of bone and joint surgery. American volume · 2012Article
- Article
- Inequalities in primary care management of knee pain and disability in older adults: an observational cohort study.Rheumatology (Oxford, England) · 2011Article
- The association of disability and pain with individual and community socioeconomic status in people with hip osteoarthritis.The open rheumatology journal · 2011Article
- Unstated factors in orthopaedic decision-making: a qualitative study.BMC musculoskeletal disorders · 2010Article
- Equity in access to total joint replacement of the hip and knee in England: cross sectional study.BMJ (Clinical research ed.) · 2010Article
Corrections and comments
- Commented on by
Authors and funding
5 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo quantify the effects of socioeconomic deprivation and rurality on evidence of need for total knee joint replacement and the use of health services, after adjusting for age and sex.
methodsA random stratified sample of 15 000 people aged > or =65 years taken from central age/sex registers for the geographical areas covered by the previous Sheffield and Wiltshire Health Authorities. A self completion validated questionnaire was then mailed directly to subjects to assess need for knee joint replacement surgery and whether general practice and hospital services were being used. Subjects were followed up for 18 months to evaluate access to surgery.
resultsThe response rate was 78% after three mailings. In those aged 65 years and over (with and without comorbidity), the proportion with no comorbid factors and in need of knee replacement was 5.1%; the rate of need among subjects without comorbidity was 7.9%. There were inequalities in health and access to health related to age, sex, geography, and deprivation but not rurality. People who were more deprived had greater need. Older and deprived people were less likely to access health services. Only 6.4% of eligible people received knee replacement surgery after 18 months of follow up.
conclusionsThere is an important unmet need in older people, with significant age, sex, geographical, and deprivation inequalities in levels of need and access to services. The use of waiting list numbers as a performance indicator is perverse for this procedure. There is urgent need to expand orthopaedic services and training.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.