Knee Replacement Tough on Minority Groups

NEW YORK (Reuters Health) - Black and Hispanic patients experience higher complication rates after total knee arthroplasty, but not after hip arthroplasty, according to a study in which doctors compared the rate of medical and surgical complications and death rates between a group of white, black, and Hispanic adults who had knee or hip arthroplasty between 1996 and 2000.

More than 90 percent of the patients of each racial/ethnic group experienced no complications within 30 days of either type of arthroplasty, the authors report in the journal Arthritis and Rheumatism.

However, non-infection-related complications after knee arthroplasty were highest among blacks (3.5 percent), they found.

Infection-related complications after knee arthroplasty were similar for blacks (4.7 percent) and Hispanics (5.2 percent) but lower for whites (3.6 percent).

Complication rates did not differ after hip arthroplasty among the three groups. Also, mortality in the first 30 days following knee arthroplasty and hip arthroplasty did not differ by race/ethnicity, the report indicates.

"Apparently higher rates of various complications following knee arthroplasty among minorities remain unexplained and may represent a quality-of-care issue," Dr. Said A. Ibrahim from VA Pittsburgh Healthcare System and University of Pittsburgh and colleagues conclude.

"Additional quality-of-care studies should focus on identifying the underlying reasons for these differences in complication rates while examining other factors that contribute to the marked racial/ethnic disparities in the utilization of joint arthroplasty."

SOURCE: Arthritis and Rheumatism, October 2005.