Perioperative Outcomes in Total Knee Arthroplasty for Non-English Speakers

Background: Many studies have demonstrated that in patients whose primary language is not English, outcomes after an orthopaedic surgery are worse compared to primary English speakers. The goal of this study was to compare perioperative outcomes in patients undergoing total knee arthroplasty (TKA) who prefer English as their first language versus those who prefer a different language. Methods: We retrospectively reviewed all patients who underwent primary TKA from May 2012 to July 2021. Patients were separated into two groups based on whether English was their preferred primary language (PPL). Of the 13,447 patients who underwent primary TKA, 11,290 reported English as their PPL, and 2,157 preferred a language other than English. Patients whose PPL was not English were further stratified based on whether they requested interpreter services. Multiple regression analyses were performed to determine the significance of perioperative outcomes while controlling for demographic differences. Results: Our analysis found that non-English PPL patients had significantly lower rates of readmission (P =.040), overall revision (P =.028), and manipulation under anesthesia (MUA; P =.025) within 90 days postoperatively. Sub analyses of the non-English PPL group showed that those who requested interpreter services had significantly lower 1-year revision (P <.001) and overall MUA (P =.049) rates. Conclusion: Our results demonstrate that TKA patients who communicated in English without an interpreter were significantly more likely to undergo revision, readmission, and MUA. These findings may suggest that language barriers may make it more difficult to identify postoperative problems or concerns in non-English speakers, which may limit appropriate postoperative care. Level III Evidence: Retrospective Cohort Study. (c) 2023 Elsevier Inc. All rights reserved.

Automated summary

The study compared perioperative outcomes in patients undergoing total knee arthroplasty who prefer English as their first language versus those who prefer a different language. The results showed that patients whose primary language was not English had lower rates of readmission, overall revision, and manipulation under anesthesia within 90 days postoperatively. Sub analyses showed that among non-English speakers, those who requested interpreter services also had lower rates of revision and overall manipulation under anesthesia within 1 year.