4.2 Article

Racial Disparities in Total Joint Arthroplasty

Journal

CURRENT REVIEWS IN MUSCULOSKELETAL MEDICINE
Volume 14, Issue 6, Pages 434-440

Publisher

SPRINGER
DOI: 10.1007/s12178-021-09718-3

Keywords

Racial disparities; Total joint replacement; Total knee replacement; Total hip replacement

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Racial and ethnic disparities in total joint arthroplasty are present in all phases of care, impacting access to, utilization of, and postoperative outcomes. Factors such as increased comorbidities, lower socioeconomic status, and Medicaid/uninsured status limit patient access and are disproportionately associated with underrepresented patient populations. Minority patients often require more intensive postoperative rehabilitation and non-home discharge, indicating the need for multifaceted solutions to address disparities on both systemic and individual levels.
Purpose of Review The primary aim of this review was to evaluate recently published total joint arthroplasty (TJA) studies in order to accurately summarize the current concepts regarding racial and ethnic disparities in total joint arthroplasty. Recent Findings Many studies found that racial and ethnic disparities in TJA are present in all phases of arthroplasty care including access to, utilization of, and postoperative outcomes after TJA. Factors that limit patient access to TJA-increased patient comorbidities, lower socioeconomic status, and Medicaid/uninsured status-are also disproportionately associated with underrepresented patient populations. Minority patients are more likely to require more intensive postoperative rehabilitation and non-home discharge placement. This in turn potentially adds additional concerns regarding hospital/provider reimbursement in light of the current Medicare/Medicaid model for arthroplasty surgeons, thus creating a recurrent cycle in which disparities in TJA reflect the complex interplay of overall health disparities and access inequalities associated with racial and ethnic biases. Literature demonstrating evidenced-based interventions to minimize these disparities is sparse, but the multifactorial cause of disparities in TJA highlights the need for multifaceted solutions on both a systemic and individual level.

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