Osteoarthritis (OA) is a leading cause of limitations in activity
and work in the United States; these limitations as well as the burden
of severe pain disproportionately affect black patients. Total knee
replacement (TKR) is the most effective and cost-effective surgical
option for moderate to severe OA of the knee.
However, a significant
racial variation in the use of TKR exists, with black patients less
likely to undergo TKR compared with white patients. Black candidates for
joint replacement differ in their preferences for treatment, which are
primarily shaped by differences in understanding of treatment risks and
benefits.
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‘A patient-centered counseling and educational intervention that describes the risks and benefits of total knee replacement surgery significantly increased the rate of this surgery among black patients.’
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A decision aid that consisted of a video that describes the risks and benefits of total knee replacement surgery significantly increased the rate of this surgery among black patients, revealed a study published online by JAMA Surgery.
Said A. Ibrahim of the University of
Pennsylvania Perelman School of Medicine, Philadelphia, and colleagues
randomly assigned 336 study participants (self-identified as black, 50
years or older with chronic and frequent knee pain, and radiographic
evidence of OA) to access to a decision aid for OA of the knee (a
40-minute video that describes the risks and benefits of TKR surgery) or
control (receipt of an educational booklet).
![4.5 Million Americans Living With Total Knee Replacement]( "4.5 Million Americans Living With Total Knee Replacement")
A new research has found increase in total knee replacement surgeries among Americans.
Among the patients (70% women; average age, 59 years), 13 of 168 controls (7.7%) and 25 of 168 intervention patients (14.9%) underwent TKR within 12 months. These changes represent a 70% increase in the TKR rate, which increased by 86% (7.1% vs 15.3%) in the per-protocol sample. The decision aid also increased by about 30% the receipt of a recommendation from an orthopedic surgeon within six months of the intervention, although this association did not achieve statistical significance. In addition, the intervention was more likely to lead to surgery among those who at baseline were willing compared with those who were unwilling, for women compared with men, and for patients ages 50 to 55 years compared with older patients.
"A patient-centered counseling and educational intervention may help to address racial variations in the use of TKR for the management of end-stage OA of the knee," the authors write.
The researchers add that future research may be needed to "explain the mechanism by which the decision aid actually leads to greater uptake of surgery among black patients and whether this method could be used to address other treatment disparities."
Source: Eurekalert
4.5 Million Americans Living With Total Knee Replacement
A new research has found increase in total knee replacement surgeries among Americans.
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Among the patients (70% women; average age, 59 years), 13 of 168 controls (7.7%) and 25 of 168 intervention patients (14.9%) underwent TKR within 12 months. These changes represent a 70% increase in the TKR rate, which increased by 86% (7.1% vs 15.3%) in the per-protocol sample. The decision aid also increased by about 30% the receipt of a recommendation from an orthopedic surgeon within six months of the intervention, although this association did not achieve statistical significance. In addition, the intervention was more likely to lead to surgery among those who at baseline were willing compared with those who were unwilling, for women compared with men, and for patients ages 50 to 55 years compared with older patients.
"A patient-centered counseling and educational intervention may help to address racial variations in the use of TKR for the management of end-stage OA of the knee," the authors write.
The researchers add that future research may be needed to "explain the mechanism by which the decision aid actually leads to greater uptake of surgery among black patients and whether this method could be used to address other treatment disparities."
Source: Eurekalert
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Knee replacement is a common, successful surgery in orthopaedics, however, despite comparable clinical results, some patients are not satisfied.
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