The Center for Disease Control's (CDC) Morbidity and Mortality Weekly Report (MMWR) has issued a report stating concern over racial disparities in the United States in obtaining total knee replacements.

The report states that 45% of U.S. adults might be at risk for developing symptomatic knee osteoarthritis during their lifetimes. The MMWR says that whites and blacks have equal risk for knee osteoarthritis. Total knee replacement (TKR) is a known effective method of reducing pain and improving physical function among those with the condition, however, the MMWR says, more whites are likely to have the procedure than blacks. The MMWR says that its Healthy People 2010 objective calls for eliminating racial disparities in the rate of TKR among persons aged 65 years and up.

According to the MMWR's report, the CDC analyzed national and state TKR rates for Medicare enrollees for the period 2000--2006, by sex, age group, and race demographics. From 2000 to 2006, the TKR rate overall in the United States increased 58%, from 5.5 to 8.7 per 1,000 population. The overall increase was similar among whites (61%) and blacks (56%). However, the MMWR says, the TKR rate for blacks was 37% lower than the rate for whites in 2000 (3.6 versus 5.7 per 1,000 population) and 39% lower in 2006 (5.6 versus 9.2 per 1,000 population).

The report states, "Health-care providers and public health agencies might help reduce this disparity by widely distributing TKR information that is tailored to the education and literacy levels and culture of patients with symptomatic knee osteoarthritis." The report also recommends that health-care providers routinely have discussions about knee pain and function with older patients of all races who might be TKR candidates.

The MMWR stresses that the disparity is "an important social and public health problem," and notes the concern that through 2000 to 2006, the disparity in rates between whites and blacks persisted in the nation overall and actually increased in 19 states. The report reviews some possible multifactorial causes for the disparity, including communication gaps and inaccurate information.

Information summarized from a report from the MMWR, Racial Disparities in Total Knee Replacement Among Medicare Enrollees --- United States, 2000-2006.

Link: http://www.cdc.gov/mmwR/preview/mmwrhtml/mm5806a1.htm

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