ArticleJournal of general internal medicine2010
The effect of patient race on total joint replacement recommendations and utilization in the orthopedic setting.
Article in Journal of general internal medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 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
62 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Are There Racial and Ethnic Variations in Patient Attitudes Toward Hip and Knee Arthroplasty for Osteoarthritis? A Systematic Review.Clinical orthopaedics and related research · 2024Pooled it
- Is Our Science Representative? A Systematic Review of Racial and Ethnic Diversity in Orthopaedic Clinical Trials from 2000 to 2020.Clinical orthopaedics and related research · 2022Pooled it
- Disparities in Surgical Access: A Systematic Literature Review, Conceptual Model, and Evidence Map.Journal of the American College of Surgeons · 2019Pooled it
- Effect of a Positive Psychological Intervention on Pain and Functional Difficulty Among Adults With Osteoarthritis: A Randomized Clinical Trial.JAMA network open · 2018Trial
- Racial Variation in Total Knee Replacement in a Diverse Nationwide Clinical Trial.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2018Trial
- Effect of a Decision Aid on Access to Total Knee Replacement for Black Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial.JAMA surgery · 2017Trial
- Does a Patient-centered Educational Intervention Affect African-American Access to Knee Replacement? A Randomized Trial.Clinical orthopaedics and related research · 2016Trial
- Do patient race and sex change surgeon recommendations for TKA?Clinical orthopaedics and related research · 2015Trial
- Willingness and access to joint replacement among African American patients with knee osteoarthritis: a randomized, controlled intervention.Arthritis and rheumatism · 2013Trial
- Health Care Utilization and Equity in Medicare Advantage Compared With Traditional Medicare.JAMA network open · 2026Article
- Racial Differences in Utilization of and Factors Contributing to the Use of Knee Replacement Surgery as a Treatment for Severe Knee Osteoarthritis: A Scoping Review.Osteoarthritis and cartilage open · 2026Review
- Article
- Disparities in Outpatient and Short-Stay Arthroplasty Surgery: a Critical Review and Proposed Equity-Centered Framework.Current reviews in musculoskeletal medicine · 2026Review
- What factors impact patients' decision to undergo shoulder surgery and subjective feeling of recovery?JSES reviews, reports, and techniques · 2025Article
- Racial, socioeconomic, and payer status disparities in utilization of unicompartmental knee arthroplasty in the USA.Knee surgery & related research · 2025Article
- Area Socioeconomic Status is Associated with Refusal of Recommended Surgery in Patients with Metastatic Bone and Joint Disease.Annals of surgical oncology · 2024Article
- Racial disparities in post-operative complications and discharge destination following total joints arthroplasty: a national database study.Archives of orthopaedic and trauma surgery · 2023Article
- Characterizing the lack of diversity in musculoskeletal urgent care website content.BMC health services research · 2023Article
- Racial Disparities in Elective Total Joint Arthroplasty for Osteoarthritis.ACR open rheumatology · 2022Review
- Association of Patients' Familiarity and Perceptions of Efficacy and Risks With the Use of Opioid Medications in the Management of Osteoarthritis.The Journal of rheumatology · 2021Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
backgroundThe extent to which treatment recommendations in the orthopedic setting contribute to well-established racial disparities in the utilization of total joint replacement (TJR) in the treatment of advanced knee/hip osteoarthritis has not been explored.
objectiveTo examine whether orthopedic surgeons are less likely to recommend TJR to African-American patients compared to white patients with similar clinical indications, and whether there are racial differences in the receipt of TJR within six months of study enrollment.
designProspective, observational study.
participantsAfrican-American (AA; n = 120) and white (n = 337) patients seeking treatment for knee or hip osteoarthritis in Veterans Affairs orthopedic clinics. MAIN MEASURES: Patients completed surveys that assessed socio-demographic and clinical variables that could influence osteoarthritis treatment. Orthopedic surgeons' notes were reviewed to determine whether patients had been recommended for TJR and whether they underwent the procedure within 6 months of study enrollment.
resultsRate of TJR recommendation was 19.5%. Odds of receiving a TJR recommendation were lower for AA than white patients of similar age and disease severity (OR = 0.46, 95% CI = 0.26-0.83; P = 0.01). However, this difference was not significant after adjusting for patient preference for TJR (OR = 0.69, 95% CI = 0.36-1.31, P = 0.25). Overall, 10.3% of patients underwent TJR within 6 months. TJR was less likely for AA patients than for white patients of similar age and disease severity (OR = 0.41, 95% CI = 0.16-1.05, P = 0.06), but this difference was reduced after adjusting for whether patients had received a recommendation for the procedure at the index visit (OR = 0.57, 95% CI = 0.21-1.54, P = 0.27).
conclusionsIn this study, race differences in patient preferences for TJR appeared to underlie race differences in TJR recommendations, which led to race differences in utilization of the procedure. Our findings suggest that patient treatment preferences play an important role in racial disparities in TJR utilization in the orthopedic setting.
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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.