ArticleMedical care2008
Exploring the determinants of racial and ethnic disparities in total knee arthroplasty: health insurance, income, and assets.
Article in Medical care, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses 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
44 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Racial and Ethnic Disparities in Primary Total Knee Arthroplasty Outcomes: A Systematic Review and Meta-Analysis of Two Decades of Research.Journal of racial and ethnic health disparities · 2025Pooled it
- Determinants of demand for total hip and knee arthroplasty: a systematic literature review.BMC health services research · 2012Pooled it
- Drivers of surgery for the degenerative hip, knee, and spine: a systematic review.Clinical orthopaedics and related research · 2012Pooled it
- Do patient race and sex change surgeon recommendations for TKA?Clinical orthopaedics and related research · 2015Trial
- Striving for LGBTQI+ Health Equity in Arthroplasty.Arthroplasty today · 2026Article
- Examining racial and ethnic differences in health care expenditures among older adults with arthritis in the United States.Journal of managed care & specialty pharmacy · 2025Article
- Patient Race Independently Predicts Timeliness of Breast Cancer Reconstructive Care.Journal of clinical medicine · 2025Article
- The effect of Charlson Comorbidity Index, race, and surgical complications on postoperative knee outcomes after total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2025Article
- Racial, socioeconomic, and payer status disparities in utilization of unicompartmental knee arthroplasty in the USA.Knee surgery & related research · 2025Article
- Factors influencing the decision to receive total knee replacement among patients with severe knee osteoarthritis under universal health insurance coverage.Scientific reports · 2024Article
- Advancing Aging Research Through a Health Disparities Perspective.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Socioeconomic factors affecting outcomes in total knee and hip arthroplasty: a systematic review on healthcare disparities.Arthroplasty (London, England) · 2022Review
- Lower Rates of Ceramic Femoral Head Use in Non-White Patients in the United States, a National Registry Study.The Journal of arthroplasty · 2022Article
- Willingness to Have Total Knee Arthroplasty in Rural Areas of Northern China.Orthopaedic surgery · 2022Article
- Disparities across Diverse Populations in the Health and Treatment of Patients with Osteoarthritis.Healthcare (Basel, Switzerland) · 2021Review
- Influence of psychosocial and sociodemographic factors in the surgical management of traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States.Journal of spine surgery (Hong Kong) · 2021Article
- Racial/Ethnic and Socioeconomic Disparities in Osteoarthritis Management.Rheumatic diseases clinics of North America · 2021Review
- First Reported Series of Outpatient Total Knee Arthroplasty in the Middle East.Arthroplasty today · 2020Article
- Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016.BMC health services research · 2020Article
- Racial/Ethnic Disparities in Physical Function Before and After Total Knee Arthroplasty Among Women in the United States.JAMA network open · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectiveTo estimate national total knee arthroplasty (TKA) rates by economic factors, and the extent to which differences in insurance coverage, income, and assets contribute to racial and ethnic disparities in TKA use. DATA SOURCE: US longitudinal Health and Retirement Study survey data for the elderly and near-elderly (biennial rounds 1994-2004) from the Institute of Social Research, University of Michigan. STUDY
designThe outcome is dichotomous, whether the respondent received first TKA in the previous 2 years. Longitudinal, random-effects logistic regression models are used to assess associations with lagged economic indicators. SAMPLE: Sample was 55,469 person-year observations from 18,439 persons; 663, with first TKA.
resultsRacial/ethnic disparities in TKA were more prominent among men than women. For example, relative to white women, odds ratios (ORs) were 0.94, 0.46, and 0.79, for white, black, and Hispanic men, respectively (P < 0.05 for black men). After adjusting for economic factors, racial/ethnic differences in TKA rates for women essentially disappeared, while the deficit for black men remained large. Among Medicare-enrolled elderly, those with supplemental insurance may be more likely to have first TKA compared with those without it, whether the supplemental coverage was private [OR: 1.27; 95% confidence interval (CI): 0.82-1.96] or Medicaid (OR: 1.18; 95% CI: 0.93-1.49). Among the near-elderly (age 47-64), compared with the privately insured, the uninsured were less likely (OR: 0.61; 95% CI: 0.40-0.92) and those with Medicaid more likely (OR: 1.53; 95% CI: 1.03-2.26) to have first TKA.
conclusionsLimited insurance coverage and financial constraints explain some of the racial/ethnic disparities in TKA rates.
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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.