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Knee News

Race for Hip and Knee Joint Replacements

Consider these facts. Americans 85 years old and older are the fastest growing age group in the United States. Americans of Hispanic or Latino descent are the largest minority group in the United States. The number of Black Americans is rising and expected to keep increasing. Black and Hispanic adults are less likely to have a joint replacement when needed compared to white adults.

In this study researchers looked at uninsured minority patients. The goal was to find out if these patients have more serious arthritis than insured white adults at the time of joint replacement. Over 700 patients who had a hip or knee replacement were included in the study.

The patients were divided into four groups: 1) Hispanic white, 2) Non-hispanic white, 3) Hispanic black, and 4) Non-hispanic black. Slightly more than half identified themselves as Hispanic. Pain, function, and quality of life were measured for each patient.

This is the first study to look at the link between race and ethnicity and type of insurance with health status at the time of joint replacement surgery. They found race and ethnicity was a stronger predictor of outcome than insurance status. The type of insurance didn't seem to have as much bearing on patient function before surgery. Patients without coverage of any kind had the lowest function and poorest health before joint replacement.

Blacks and hispanics have more pain and less function than whites at the time of their joint replacement. The authors aren't sure why this happens. There may be cultural or language barriers. Or there may be genetic factors leading to more severe disease in blacks.

More studies are needed to answer these questions. From this study here's what we know that non-hispanic black patients have more advanced disease when they have a joint replacement done compared to others. And black males are the least likely to seek joint replacement for arthritis.

Fact: The number of hip and joint replacements in these groups is 1/2 million each year and expected to increase in future years.


Carlos J. Lavernia, MD, et al. Race, Ethnicity, Insurance Coverage, and Preoperative Status of Hip and Knee Surgical Patients. In The Journal of Arthroscopy. December 2004. Vol. 19. No. 8. Pp. 978-985.

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