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Racial Disparities Found in Total Knee Replacement

Arthritis Care Res; ePub 2018 Jan 24; Kerman, et al

Black Americans lose 72,000 quality-adjusted life years (QALYs) due to disparities in total knee replacement (TKR) offer and complication rates, a recent study found. Therefore, programs to decrease disparities in TKR use are urgently needed. Researchers used the Osteoarthritis Policy Model, a computer simulation of knee osteoarthritis (OA), to predict QALY outcomes for black and white knee OA patients with and without TKR. They estimated per-person QALYs gained from TKR as the difference between QALYs with current TKR use and QALYs when no TKR was performed. They found:

  • Black men and women gain 64,100 QALYs from current TKR use.
  • With white offer and complications rates, they would gain an additional 72,000 QALYs.
  • Because these additional gains are unrealized, it is calculated as a loss of 72,000 QALYs.
  • Black Americans lose 67,500 QALYs because of lower offer, 15,800 QALYs because of lower acceptance, and 2,600 QALYs because of higher complications.

Citation:

Kerman HM, Smith SR, Smith KC, et al. Disparities in total knee replacement: Population losses in quality-adjusted life years due to differential offer, acceptance, and complication rates for black Americans. [Published online ahead of print January 24, 2018]. Arthritis Care Res. doi:10.1002/acr.23484.

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