当前位置: X-MOL 学术J. Arthroplasty › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Racial Disparities in Rates of Revision and use of Modern Features in Total Knee Arthroplasty, a National Registry Study
The Journal of Arthroplasty ( IF 3.5 ) Pub Date : 2022-09-24 , DOI: 10.1016/j.arth.2022.09.023
Noah D Paisner 1 , Alexander M Upfill-Brown 2 , Patrick C Donnelly 3 , Ayushmita De 3 , Adam A Sassoon 2
Affiliation  

Background

The purpose of our study was to investigate the association of race and ethnicity with rates of modern implant use and postoperative outcomes in total knee arthroplasty (TKA) using the American Academy of Orthopaedic Surgeons American Joint Replacement Registry.

Methods

Adult TKAs from 2012 to 2020 were queried from the American Joint Replacement Registry. A total of 1,121,457 patients were available for analysis for surgical features and 1,068,210 patients for analysis of outcomes. Mixed-effects multivariable logistic regression models were used to examine the association of race with each individual surgical feature (unicompartmental knee arthroplasty (UKA) and robotic-assisted TKA (RA-TKA)) and 30- and 90-day readmission. A proportional subdistribution hazard model was used to model the risk of revision TKA.

Results

On multivariate analyses, compared to White patients, Black (odds ratio (OR): 0.52 P < .0001), Hispanic (OR 0.75 P < .001), and Native American (OR: 0.69 P = .0011) patients had lower rates of UKA, while only Black patients had lower rates of RA-TKA (OR = 0.76 P < .001). White (hazard ratio (HR) = 0.8, P < .001), Asian (HR = 0.51, P < .001), and Hispanic-White (HR = 0.73, P = .001) patients had a lower risk of revision TKA than Black patients. Asian patients had a lower revision risk than White (HR = 0.64, P < .001) and Hispanic-White (HR = 0.69, P = .011) patients. No significant differences existed between groups for 30- or 90-day readmissions.

Conclusion

Black, Hispanic, and Native American patients had lower rates of UKA compared to White patients, while Black patients had lower rates of RA-TKA compared to White, Asian, and Hispanic patients. Black patients also had higher rates of revision TKA than other races.



中文翻译:

全膝关节置换术中翻修率和使用现代特征的种族差异,一项国家注册研究

背景

我们的研究目的是使用美国骨科医师学会美国关节置换登记处调查种族和族裔与现代植入物使用率和全膝关节置换术 (TKA) 术后结果之间的关系。

方法

从美国关节置换登记处查询了 2012 年至 2020 年的成人 TKA。共有 1,121,457 名患者可用于手术特征分析,1,068,210 名患者可用于结果分析。混合效应多变量逻辑回归模型用于检查种族与每个单独手术特征(单间室膝关节置换术 (UKA) 和机器人辅助 TKA (RA-TKA))以及 30 天和 90 天再入院的关联。使用比例子分布风险模型来模拟 TKA 翻修的风险。

结果

在多变量分析中,与白人患者相比,黑人(比值比 (OR):0.52 P < .0001)、西班牙裔(OR 0.75 P < .001)和美洲原住民(OR:0.69 P  = .0011)患者的患病率较低UKA,而只有黑人患者的 RA-TKA 发生率较低 (OR = 0.76 P < .001)。白人(风险比 (HR) = 0.8,P < .001)、亚裔(HR = 0.51,P < .001)和西班牙裔白人(HR = 0.73,P  = .001)患者的 TKA 翻修风险较低比黑人患者。亚裔患者的翻修风险低于白人 (HR = 0.64, P < .001) 和西班牙裔白人 (HR = 0.69, P = .011) 患者。对于 30 天或 90 天的再入院率,各组之间不存在显着差异。

结论

与白人患者相比,黑人、西班牙裔和美洲原住民患者的 UKA 发生率较低,而与白人、亚裔和西班牙裔患者相比,黑人患者的 RA-TKA 发生率较低。黑人患者的 TKA 翻修率也高于其他种族。

更新日期:2022-09-24
down
wechat
bug