ArticleArthritis research & therapy2015
Determinants of patient preferences for total knee replacement: African-Americans and whites.
Article in Arthritis research & therapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- 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
- What's important for recovery after a total knee replacement? A systematic review of mixed methods studies.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Racial-Ethnic Differences in Osteoarthritis Pain and Disability: A Meta-Analysis.The journal of pain · 2019Pooled it
- Variability in Affect and Willingness to Take Medication.Medical decision making : an international journal of the Society for Medical Decision Making · 2018Trial
- Racial and Insurance Disparities in Percutaneous Vertebral Augmentation and Postoperative Healthcare Utilization for Osteoporotic Vertebral Fractures: A National Inpatient Sample Analysis.Journal of racial and ethnic health disparities · 2026Article
- Article
- Diffusion model-empowered patella shape analysis predicts knee osteoarthritis outcomes.Osteoarthritis and cartilage open · 2025Article
- A virtual knee replacement (vKR) multi-component endpoint for knee osteoarthritis based on patient-reported PROs: Data from the Osteoarthritis Initiative.Osteoarthritis and cartilage · 2025Article
- Evaluating the Disparate Use of Knee Arthroplasty Among Minorities Using Social Vulnerability Index.Arthroplasty today · 2025Article
- Biopsychosocial Determinants for Total Knee Replacement Decisions Among Older Adults With Chronic Knee Osteoarthritis: A Scoping Review.Geriatric orthopaedic surgery & rehabilitation · 2025Review
- Awareness and Underlying Factors for Total Knee Arthroplasty Reluctance in Saudi Arabia.Cureus · 2024Article
- Evaluating Public Perceptions and Attitudes Toward Total Knee Arthroplasty: A Cross-Sectional Study in Saudi Arabia.Cureus · 2023Article
- Disparities in postoperative total shoulder arthroplasty outcomes between Black and White patients.JSES international · 2023Article
- Prediction of total knee replacement using deep learning analysis of knee MRI.Scientific reports · 2023Article
- Awareness about total knee replacement among Saudi population.Journal of family medicine and primary care · 2022Article
- Racial Disparities in Elective Total Joint Arthroplasty for Osteoarthritis.ACR open rheumatology · 2022Review
- Time Trends in Perioperative Characteristics and Health Outcomes in Hispanic Patients Undergoing Primary Total Knee Arthroplasty.Journal of racial and ethnic health disparities · 2021Article
- Racial Disparities in Total Joint Arthroplasty.Current reviews in musculoskeletal medicine · 2021Review
- Disparities across Diverse Populations in the Health and Treatment of Patients with Osteoarthritis.Healthcare (Basel, Switzerland) · 2021Review
- Where Do We Stand Today on Racial and Ethnic Health Inequities? Analysis of Primary Total Knee Arthroplasty from a 2011-2017 National Database.Journal of racial and ethnic health disparities · 2021Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
introductionPatient preferences contribute to marked racial disparities in the utilization of total knee replacement (TKR). The objectives of this study were to identify the determinants of knee osteoarthritis (OA) patients' preferences regarding TKR by race and to identify the variables that may mediate racial differences in willingness to undergo TKR.
methodsFive hundred fourteen White (WH) and 285 African-American (AA) patients with chronic knee pain and radiographic evidence of OA participated in the study. Participants were recruited from the community, an academic medical center, and a Veterans Affairs hospital. Structured interviews were conducted to collect socio-demographics, disease severity, socio-cultural determinants, and treatment preferences. Logistic regression was performed, stratified by race, to identify determinants of preferences. Clinical and socio-cultural factors were entered simultaneously into the models. Stepwise selection identified factors for inclusion in the final models (p < 0.20).
resultsCompared to WHs, AAs were less willing to undergo TKR (80 % vs. 62 %, respectively). Better expectations regarding TKR surgery outcomes determined willingness to undergo surgery in both AAs (odds ratio (OR) 2.08, 95 % confidence interval (CI) 0.91-4.79 for 4(th) vs. 1(st) quartile) and WHs (OR 5.11, 95 % CI 2.31-11.30 for 4(th) vs. 1(st) quartile). Among AAs, better understanding of the procedure (OR 1.80, 95 % CI 0.97-3.35), perceiving a short hospital course (OR 0.81, 95 % CI 0.58-1.13), and believing in less post-surgical pain (OR 0.73, 95 % CI 0.39-1.35) and walking difficulties (OR 0.66, 95 % CI 0.37-1.16) also determined willingness. Among WHs, having surgical discussion with a physician (OR 1.96, 95 % CI 1.05-3.68), not ever receiving surgical referral (OR 0.56, 95 % CI 0.32-0.99), and higher trust in the healthcare system (OR 1.58, 95 % CI 0.75-3.31 for 4(th) vs. 1(st) quartile) additionally determined willingness. Among the variables considered, only knowledge-related matters pertaining to TKR attenuated the racial difference in knee OA patients' treatment preference.
conclusionsExpectations of surgical outcomes influence preference for TKR in all patients, but clinical and socio-cultural factors exist that shape marked racial differences in preferences for TKR. Interventions to reduce or eliminate racial disparities in the utilization of TKR should consider and target these factors.
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