Evidence map›Paper›PMID 39789618›Full record

ArticleKnee surgery & related research2025

Racial, socioeconomic, and payer status disparities in utilization of unicompartmental knee arthroplasty in the USA.

Suraj A Dhanjani, Jessica Schmerler, Nauman Hussain, Daniel Badin, Uma Srikumaran, Vishal Hegde, Julius K Oni

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Knee surgery & related research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
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

7 authors.

Suraj A Dhanjani *Department of Orthopedic Surgery, Mount Sinai Health System, 5 East 98 Street, New York, NY, 10029, USA.
Jessica Schmerler *Department of Orthopedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St., Baltimore, MD, 21287, USA.ORCID http://orcid.org/0000-0002-3650-9883
Nauman HussainDepartment of Orthopedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St., Baltimore, MD, 21287, USA.
Daniel BadinDepartment of Orthopedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St., Baltimore, MD, 21287, USA.
Uma SrikumaranDepartment of Orthopedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St., Baltimore, MD, 21287, USA.
Vishal HegdeDepartment of Orthopedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St., Baltimore, MD, 21287, USA.
Julius K OniDepartment of Orthopedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St., Baltimore, MD, 21287, USA. joni1@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnicompartmental knee arthroplasty (UKA) is a surgical treatment for knee osteoarthritis associated with lower morbidity compared with total knee arthroplasty (TKA) in patients with isolated unicompartmental knee arthritis. As disparities have been noted broadly in arthroplasty care, it follows that such disparities might be present in the utilization of UKA relative to TKA. This study therefore examined racial/ethnic, socioeconomic, and payer status differences in utilization of UKA.

methodsPatients who underwent UKA or TKA between 2016 and 2020 in the National Inpatient Sample were identified. Multivariable Poisson regression models adjusted for hospital geographic region and patient characteristics [age, sex, and Elixhauser Comorbidity Index (ECI)] were used to examine the effect of race/ethnicity, socioeconomic status, and payer status on incidence rate ratio of UKA relative to TKA.

resultsOf the 8472 UKA patients and 639,937 TKA patients identified between 2016 and 2020, 8027 (94.7%) UKA patients and 606,028 (94.7%) TKA patients met inclusion criteria. Patients who underwent UKA were significantly younger (63.5 ± 10.7 years) than patients who underwent TKA (66.8 ± 9.5 years; p < 0.001) and had significantly lower ECI scores (1.8 ± 1.5) than patients who underwent TKA (2.2 ± 1.6; p < 0.001). Black patients were less likely to undergo UKA relative to TKA compared with white patients [incidence rate ratio (IRR) 0.64, confidence interval (CI) 0.58-0.71, p < 0.001]. Compared with patients in income quartile 4, patients in income quartiles 1 and 2 underwent UKA at a lower relative rate (IRR 0.85, CI 0.79-0.90, p < 0.001 and IRR 0.87, CI 0.82-0.93, p < 0.001, respectively). Compared with patients with private insurance, patients with Medicare underwent UKA at a lower relative rate (IRR 0.83, CI 0.79-0.88, p < 0.001).

conclusionsBlack patients, lower-income patients, and Medicare-insured patients undergo UKA at a lower relative rate than white, higher-income, and privately insured patients, respectively. Further research may help elucidate reasons for these differences and identify targets for intervention.

Indexed as

Payer status disparitiesRacial disparitiesSocioeconomic disparitiesTotal knee arthroplastyUnicompartmental knee arthroplasty

Identifiers

PMID39789618
PMCPMC11720326

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.