Trial reportJournal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases2018
Racial Variation in Total Knee Replacement in a Diverse Nationwide Clinical Trial.
Trial report in Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis 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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Racial-Ethnic Differences in Osteoarthritis Pain and Disability: A Meta-Analysis.The journal of pain · 2019Pooled it
- Racial Differences in Pain and Function Following Knee Arthroplasty: A Secondary Analysis From a Multicenter Randomized Clinical Trial.Arthritis care & research · 2021Trial
- The Effects of Vitamin D and Marine Omega-3 Fatty Acid Supplementation on Chronic Knee Pain in Older US Adults: Results From a Randomized Trial.Arthritis & rheumatology (Hoboken, N.J.) · 2020Trial
- Sociodemographic Differences in Long-Term Function After Total Hip and Knee Arthroplasty: A Scoping Review.Orthopaedic surgery · 2025Article
- Evaluating the Disparate Use of Knee Arthroplasty Among Minorities Using Social Vulnerability Index.Arthroplasty today · 2025Article
- Association of Knee Osteoarthritis Treatment Types, Patient Characteristics, and Medical History With Subsequent Risk for Total Knee Arthroplasty: Data From a New Real-World Registry.Arthroplasty today · 2025Article
- Racial variations in complications and costs following total knee arthroplasty: a retrospective matched cohort study.Archives of orthopaedic and trauma surgery · 2024Article
- Total Joint Arthroplasty Direct-to-Consumer Advertising by Medical Device Companies Lacks Patient Diversity.Arthroplasty today · 2022Article
- Superoxide dismutase-loaded porous polymersomes as highly efficient antioxidant nanoparticles targeting synovium for osteoarthritis therapy.Biomaterials · 2022Article
- Racial Disparities in Elective Total Joint Arthroplasty for Osteoarthritis.ACR open rheumatology · 2022Review
- Applying the NIA Health Disparities Research Framework to Identify Needs and Opportunities in Chronic Musculoskeletal Pain Research.The journal of pain · 2022Review
- 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
- Does racial background influence outcomes following total joint arthroplasty?Journal of clinical orthopaedics and trauma · 2021Article
- Effects of education, income, and occupation on prevalence and symptoms of knee osteoarthritis.Scientific reports · 2021Article
- Racial/Ethnic and Socioeconomic Disparities in Osteoarthritis Management.Rheumatic diseases clinics of North America · 2021Review
- Article
- Quantifying Mediators of Racial Disparities in Knee Osteoarthritis Outcome Scores: A Cross-Sectional Analysis.JB & JS open accessArticle
- "Bearing the Pain": The Experience of Aging African Americans With Osteoarthritis Pain.Global qualitative nursing researchArticle
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveRacial variation in total knee replacement (TKR) utilization in the United States has been reported in administrative database studies. We investigated racial variation in TKR procedures in a diverse cohort with severe knee pain followed in an ongoing clinical trial.
methodsVITAL (VITamin D and OmegA-3 TriaL) is a nationwide, randomized controlled trial of 25,874 adults, 20% of whom are black. We identified a subgroup highly likely to have knee osteoarthritis based on severity of knee pain, physician-diagnosed knee osteoarthritis, and inability to walk 2 to 3 blocks without pain. Participants completed a modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and self-reported incident TKR annually in follow-up. Using Cox regression, we analyzed the association of black versus white race with TKR, adjusting for demographic and socioeconomic characteristics, comorbidities, and WOMAC pain and function.
resultsAmong 1070 participants who met the inclusion criteria, black participants reported worse baseline WOMAC pain (45 vs. 32, P < 0.001) and worse function (45 vs. 32, P < 0.001). During a median of 3.6 years (interquartile range, 3.2, 3.8 years) of follow-up, TKRs were reported by 180 participants. Black participants were less likely to undergo TKR (11% vs. 19%). After adjustment, the hazard ratio for TKR for black versus white participants was 0.51 (95% confidence interval, 0.32-0.81). Lower use of TKR among black participants was observed across all levels of income and education.
conclusionsDespite worse baseline knee pain and function, black participants had much lower adjusted risk of having TKR than white participants, demonstrating persistent racial disparity in TKR utilization.
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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.