ArticleThe Journal of bone and joint surgery. American volume2006
The influence of income and race on total knee arthroplasty in the United States.
Article in The Journal of bone and joint surgery. American volume, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
What it found
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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
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Application of Medicare Data for Musculoskeletal Research in the United States: A Systematic Review.The Journal of the American Academy of Orthopaedic Surgeons · 2019Pooled it
- Drivers of surgery for the degenerative hip, knee, and spine: a systematic review.Clinical orthopaedics and related research · 2012Pooled it
- Racial Variation in Total Knee Replacement in a Diverse Nationwide Clinical Trial.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2018Trial
- Association Between Regional Social Vulnerability and Race-Based Differences in Total Knee Arthroplasty Use Among Medicare Beneficiaries.Arthroplasty today · 2026Article
- Elevated Distressed Community Index Score is Associated With Adverse Outcomes Following Hip Fracture Surgery in the Medicare Population.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Socioeconomic differences in access to scoliosis care in the pediatric population.Spine deformity · 2024Article
- Lower Income and Nonheterosexual Orientation Are Associated With Poor Access to Care in Patients With Knee Osteoarthritis.Arthroplasty today · 2024Article
- Surgical versus nonsurgical treatment selection patterns among Asian American patients with pelvic floor disorders: a matched cohort study.International urogynecology journal · 2023Observational
- Addressing chronic pain disparities between Black and White people: a narrative review of socio-ecological determinants.Pain management · 2023Review
- Comparing Race/Ethnicity and Zip Code Socioeconomic Status for Surgical versus Nonsurgical Management of Proximal Humerus Fractures in a Medicare Population.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Article
- Gender and Racial Diversity Among the Head Medical and Athletic Training Staff of Women's Professional Sports Leagues.Orthopaedic journal of sports medicine · 2023Article
- Socioeconomic factors affecting outcomes in total knee and hip arthroplasty: a systematic review on healthcare disparities.Arthroplasty (London, England) · 2022Review
- The Proportion of Marginalized Individuals in US Communities and Hospital Participation in Bundled Payments.Population health management · 2022Article
- Racial Differences in Pain, Nutrition, and Oxidative Stress.Pain and therapy · 2022Review
- Current Perceptions of Diversity Among Head Team Physicians and Head Athletic Trainers: Results Across US Professional Sports Leagues.Orthopaedic journal of sports medicine · 2021Article
- Factors Affecting Patient Decision-Making Regarding Midshaft Clavicle Fracture Treatment.Cureus · 2020Article
- Are There Nationwide Socioeconomic and Demographic Disparities in the Use of Outpatient Orthopaedic Services?Clinical orthopaedics and related research · 2020Article
- Racial and ethnic disparities in utilization of total knee arthroplasty among older women.Osteoarthritis and cartilage · 2019Article
- Shoulder Arthroplasty Utilization Based on Race - Are Black Patients Underrepresented?The archives of bone and joint surgery · 2019Article
- Racial Disparities in Revision Total Knee Arthroplasty: Analysis of 125,901 Patients in National US Private Payer Database.Journal of racial and ethnic health disparities · 2019Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundThe associations among income, total knee arthroplasty, and underlying rates of knee osteoarthritis are not well understood. We studied whether high-income Medicare recipients are more likely to have a knee arthroplasty and less likely to suffer from knee osteoarthritis.
methodsTwo data sources were used: (1) the 2000 United States Medicare claims data measuring the incidence of total knee arthroplasty by race, ethnicity, zip (postal) code income, and region (n = 27.5 million) and (2) the National Health and Nutrition Examination Survey (NHANES III) for individuals with an age of sixty years or more (n = 1926) with radiographic and clinical evidence of osteoarthritis. Logistic regression methods were used to adjust for covariates.
resultsAt the national level, age-adjusted rates of total knee arthroplasty in the high-income quintile were no higher than those in the low-income group (odds ratio, 0.98; 95% confidence interval, 0.96 to 1.00). Within regions, access to care was better for high-income groups (odds ratio, 1.19; 95% confidence interval, 1.17 to 1.22). Racial disparities in arthroplasty were significant (p < 0.001); the odds ratio was 0.36 (95% confidence interval, 0.34 to 0.38) for black men and 0.45 (95% confidence interval, 0.41 to 0.49) for Asian women. There was no evidence of an income gradient for most clinical and radiographic measures of arthritis. The exception was a significant negative association between income and pain on passive motion (p < 0.05).
conclusionsHigh-income Medicare enrollees are no less likely to have osteoarthritis than low-income enrollees but have somewhat better access to care. Racial disparities are more important than those that are attributable to socioeconomic status.
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