FORT LAUDERDALE, FLA. – Whites with osteoarthritis are twice as likely as are African Americans or Hispanics to have joint replacement surgery, and differences in access to care and socioeconomic status do not explain the disparity, according to a presentation at the World Congress on Osteoarthritis.
Overall, Hispanics are less familiar with the surgery. An educational intervention targeted toward ethnic patients could reduce this disparity, Dr. Maria Suarez-Almazor said at the meeting, which was sponsored by the Osteoarthritis Research Society International.
Researchers explored the “striking disparity” in the number of total joint replacement procedures between white and non-white patients in focus groups and a survey of nearly 200 people with knee osteoarthritis.
Willingness to undergo surgery depended upon a need to feel ready for the procedure and a belief that no other options remain, according to focus groups of people with knee osteoarthritis. Inner beliefs, familiarity with the surgery, trust in their physicians, and advice from others who had the procedure were also considered important. There were two focus groups of whites, two groups of African Americans, and two groups of Hispanics.
To assess cultural differences more quantitatively, Dr. Suarez-Almazor and her associates surveyed 198 patients with knee osteoarthritis via telephone or in person.
Findings were adjusted for age, education, and other differences. “Access to care and socioeconomic status alone cannot explain the variation,” Dr. Suarez-Almazor said.
White respondents had considered total knee replacement on their own the most often (42%), compared with 30% of African Americans and 25% of Hispanics, said Dr. Suarez-Almazor, professor in the department of general internal medicine, ambulatory treatment, and emergency care at the University of Texas MD Anderson Cancer Center, Houston.
A total of 100% of whites reported familiarity with total knee replacement surgery compared with 91% of African Americans and 80% of Hispanics. In addition, 80% of whites versus 70% of African Americans and 58% of Hispanics said they had a relative or friend who had the surgery.
Overall, Hispanics and African Americans thought surgery would be less beneficial than did whites. In addition, Hispanics reported they were less likely to undergo the procedure than, compared with whites, even if their osteoarthritis worsened and a doctor recommended the surgery.