Peter W. Groeneveld|C. Kent Kwoh|Maria K. Mor|Cathleen J. Appelt|Ming Geng|Jennifer C. Gutierrez|Damaris S. Wessel|Said A. Ibrahim
Racial differences in expectations of joint replacement surgery outcomes
Philadelphia VA Medical Center
prior studies indicated racial differences patients expectations joint replacement surgery outcomes goal study measure differences using wellvalidated survey instrument determine differences could explained racial variation disease severity socioeconomic factors literacy trustdetailed demographic clinical psychological social data collected 909 male patients 450 african american 459 white ages 5079 years moderate severe osteoarthritis oa hip knee receiving primary care 2 veterans affairs medical centers previously validated joint replacement expectations survey used assess expectations pain relief functional improvement psychological wellbeing joint replacementamong knee oa patients n 627 unadjusted mean expectation score scale 076 african american patients 487 versus 536 white patients mean difference 49 p 0001 hip oa patients n 282 unadjusted mean expectation score scale 072 african americans 454 versus 515 whites mean difference 61 p 0001 multivariable adjustment disease severity socioeconomic factors education social support literacy trust reduced racial differences 38 points 95 confidence interval 95 ci 12 63 among knee oa patients 42 points 95 ci 04 80 among hip patientsamong potential candidates joint replacement african american patients significantly lower expectations surgical outcomes white patients difference entirely explained racial differences demographics disease severity education income social support trust