ArticleOsteoarthritis and cartilage2019
Racial and ethnic disparities in utilization of total knee arthroplasty among older women.
Article in Osteoarthritis and cartilage, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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.
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Who cites it
34 citing papers in PubMed, 83 citations in OpenAlex.
- Global, regional and national burden of osteoarthritis in women of childbearing age from 1990 to 2021, with projected trends up to 2045.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Associations of food security and food assistance with cardiovascular morbidity and mortality among postmenopausal women from the women's health initiative.Journal of epidemiology and community health · 2026Article
- Health Disparities in Orthobiologics: Factors Influencing Access to Platelet-Rich Plasma for Knee Osteoarthritis.Orthopaedic journal of sports medicine · 2026Article
- Racial disparities in pain and total knee arthroplasty across knee osteoarthritis phenotypes.Frontiers in aging · 2026Article
- Psychiatric disorders among older U.S. women by socioeconomic and veteran status.Journal of affective disorders · 2025Article
- Sociodemographic Differences in Long-Term Function After Total Hip and Knee Arthroplasty: A Scoping Review.Orthopaedic surgery · 2025Article
- Time to Total Hip Arthroplasty Among Patients in the US Military Health System.JAMA network open · 2025Article
- 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
- Evaluating the Disparate Use of Knee Arthroplasty Among Minorities Using Social Vulnerability Index.Arthroplasty today · 2025Article
- Patient race and ethnicity are associated with higher unplanned 90-day emergency department visits and readmissions but not 10-year all-cause complications or reoperations: a matched cohort analysis of primary shoulder arthroplasties.JSES reviews, reports, and techniques · 2025Article
- Racial Disparities in Total Knee and Hip Arthroplasty in a Medically Underserved Community with a Diverse Population.Journal of racial and ethnic health disparities · 2025Article
- Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients.Plastic and reconstructive surgery. Global open · 2025Article
- Strategies to Improve Equitable Access to Early Osteoarthritis Diagnosis and Management: An Updated Review.Arthritis care & research · 2025Review
- Access to robot-assisted total knee arthroplasty varies significantly by race/ethnicity.Knee surgery & related research · 2025Article
- Pathways From Socioeconomic Factors to Major Cardiovascular Events Among Postmenopausal Veteran and Nonveteran Women: Findings From the Women's Health Initiative.Journal of the American Heart Association · 2024Article
- Policies in Canada fail to address disparities in access to person-centred osteoarthritis care: a content analysis.BMC health services research · 2024Article
- Priority strategies to reduce socio-gendered inequities in access to person-centred osteoarthritis care: Delphi survey.BMJ open · 2024Article
- Multi-level strategies to improve equitable timely person-centred osteoarthritis care for diverse women: qualitative interviews with women and healthcare professionals.International journal for equity in health · 2023Article
- Identifying strategies that support equitable person-centred osteoarthritis care for diverse women: content analysis of guidelines.BMC musculoskeletal disorders · 2023Article
- Emergency Department Utilization, Hospital Admissions, and Office-Based Physician Visits Among Under-Resourced African American and Latino Older Adults.Journal of racial and ethnic health disparities · 2023Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
objectiveTo evaluate racial and ethnic disparities in utilization of total knee arthroplasty (TKA) in relation to demographic, health, and socioeconomic status variables.
designProspective study of 102,767 Women's Health Initiative postmenopausal women initially aged 50-79, examining utilization rates of primary TKA between non-Hispanic Black/African American, non-Hispanic White, and Hispanic/Latina women (hereafter referred to as Black, White, and Hispanic). A total of 8,942 Black, 3,405 Hispanic, and 90,420 White women with linked Medicare claims data were followed until time of TKA, death, or transition from fee-for-service coverage. Absolute disparities were determined using utilization rates by racial/ethnic group and relative disparities quantified using multivariable hazards models in adjusting for age, arthritis, joint pain, mobility disability, body mass index, number of comorbidities, income, education, neighborhood socioeconomic status (SES), and geographic region.
resultsTKA utilization was higher among White women (10.7/1,000 person-years) compared to Black (8.5/1,000 person-years) and Hispanic women (7.6/1,000 person-years). Among women with health indicators for TKA including diagnosis of arthritis, moderate to severe joint pain, and mobility disability, Black and Hispanic women were significantly less likely to undergo TKA after adjusting for age [Black: HR (95% confidence interval) = 0.70 (0.63-0.79); Hispanic: HR = 0.58 (0.44-0.77)]. Adjustment for SES modestly attenuated the measured disparity, but significant differences remained [Black: HR = 0.75 (0.67-0.89); Hispanic: HR = 0.65 (0.47-0.89)].
conclusionsCompared to White women, Black and Hispanic women were significantly less likely to undergo TKA after considering need and appropriateness for TKA and SES. Further investigation into personal-level and provider-level factors that may explain these disparities is warranted.
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Registered trials
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