Evidence map›Paper›PMID 29916191›Full record

ArticleJournal of racial and ethnic health disparities2019

Racial Disparities in Revision Total Knee Arthroplasty: Analysis of 125,901 Patients in National US Private Payer Database.

Martin Roche, Tsun Yee Law, Assem A Sultan, Erica Umpierrez, Anton Khlopas, Sam Rosas, Jennifer Kurowicki, Kevin Wang, Michael A Mont

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Article in Journal of racial and ethnic health disparities, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.8field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 28 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Martin RocheHoly Cross Orthopedic Institute, 5597 North Dixie Highway, Fort Lauderdale, FL, USA.
Tsun Yee LawHoly Cross Orthopedic Institute, 5597 North Dixie Highway, Fort Lauderdale, FL, USA.
Assem A SultanDepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue/A40, Cleveland, OH, 44195, USA.
Erica UmpierrezDepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue/A40, Cleveland, OH, 44195, USA.
Anton KhlopasDepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue/A40, Cleveland, OH, 44195, USA.
Sam RosasHoly Cross Orthopedic Institute, 5597 North Dixie Highway, Fort Lauderdale, FL, USA.
Jennifer KurowickiHoly Cross Orthopedic Institute, 5597 North Dixie Highway, Fort Lauderdale, FL, USA.
Kevin WangHoly Cross Orthopedic Institute, 5597 North Dixie Highway, Fort Lauderdale, FL, USA.
Michael A MontDepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue/A40, Cleveland, OH, 44195, USA. montm@ccf.org.
Cleveland Clinic · USOrthopedic Institute · USHoly Cross Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThere is a relative paucity of studies that characterized racial disparities in revision total knee arthroplasty (TKA). Therefore, this study was specifically conducted to evaluate the following: (1) incidence; (2) annual burden; (3) causes; and (4) age group distribution of revision TKA among different racial groups in the US sample population.

methodsThe PearlDiver database was utilized to identify patients with knee osteoarthritis (OA) who underwent primary then subsequent revision TKA from January 2007 to December 2014. Patients were stratified by race, and subset stratification by age was also performed. In each racial cohort, the overall incidence of revision TKA, annual revision burdens, and causes of revisions were calculated and compared. Additionally, a sub-analysis for the incidence of revision TKA stratified by age, in each cohort, was performed. Statistical analysis was performed to demonstrate revision incidence, burden, causes, and age distribution.

resultsRevision incidence and burden were the highest in the African-American cohort (12.4%, 11.1%), (p < 0.001) and was lowest in the Asian cohort (3.4%, 3.3%) (p < 0.001). Across all cohorts, mechanical complications of the joint prosthesis were the most common cause of revision followed by periprosthetic joint infection, while contracture was the least common (p < 0.001). Subset analysis by age revealed that the highest incidence of revision TKA was in patients less than 40 years old in the Caucasian cohort (27.1%). The African-American (17.8%), other races (7.9%), and Hispanic (16.5%) cohorts had the highest incidence of revision in the 40 to 64 years age range. Among the Asian (4.1%) and Native American (9.7%) cohorts, revision incidence was highest in patients older than 65 years.

conclusionThe present study demonstrated that racial disparities, highlighted by previous studies mainly in primary TKA, extend to influence revision TKA. Among the studied racial cohorts, race may affect outcomes and our results will help expand the current literature particularly on its role in revision TKA.

Indexed as

AdultAgedArthroplasty, Replacement, KneeBlack or African AmericanCohort StudiesDatabases, FactualHealthcare DisparitiesHumansInsurance Claim ReviewMiddle AgedUnited StatesWhite PeopleEthnicKneeRaceReplacementRevisionTotal knee arthroplasty

Identifiers

PMID29916191
OpenAlexW2809207916

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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.