Racial Disparities in Septic and Aseptic Total Knee Replacement Revision Risk: A Study Using Four State-wide Inpatient Databases
Approximately 4% of total knee replacement (TKR) patients require a revision surgery within five years. African Americans are 40% more likely to undergo TKR revision than whites, but whether racial disparities exist for both septic and aseptic TKR revision risk is unknown. Researchers set out to determine if racial disparities exist for both septic (due to infection) and aseptic (due to another cause, such as instability) revision surgery. They also explored whether racial disparities in TKR revision risk actually arise from poverty.
The investigators found that African American patients were at much higher risk of aseptic TKR revision than white patients, but that there were only modest racial disparities in the risk of septic TKR revision. Community poverty did not increase the risk of septic or aseptic TKR revision in either African Americans or whites.
Of note, low annual hospital TKR volume was a risk factor for septic TKR revision in both African American and white patients, and also increased the risk of aseptic TKR revision in white patients. Why the risk of aseptic revision was high for African Americans attending high TKR volume hospitals warrants further study, according to the researchers.
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