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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.


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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