Poorer Patients Often Less Happy With Knee Replacement05/31/13
FRIDAY, May 31 (HealthDay News) -- Although knee-replacement
surgery has improved dramatically over the years -- with smaller
incisions and better pain management and rehabilitation -- the
procedure's success may depend on socioeconomic factors, new
Lower-income patients are more likely to be dissatisfied and
have worse knee function than more affluent patients following knee
replacement, according to the study, which was published online
recently in the journal
Clinical Orthopaedics and Related Research.
Researchers led by Dr. Robert Barrack, of the Washington
University School of Medicine in St. Louis, examined more than 600
people who underwent knee-replacement surgery at one of five major
total joint centers across the United States. The patients, whose
average age was 54, were asked about their job, their level of
education and their income. The study also took participants'
gender and ethnicity into account.
The patients completed questionnaires following their surgery to
determine how satisfied they were with the results of the
Patients' income levels were linked to their level of
satisfaction with their knee replacement, the study revealed. Those
making less than $25,000 a year were less satisfied with the
procedure and had more limitations with their knee function after
surgery, according to a journal news release.
Income level was the only socioeconomic factor that affected
patients' satisfaction with their knee replacement, the researchers
said. Women and minority patients, however, were more likely to
report having functional limitations after surgery.
Inadequate postsurgical rehabilitation for patients with lower
incomes could help explain their findings, the researchers said.
They noted that previous studies have shown that minority patients
are more likely to be treated at hospitals that do not perform as
many knee-replacement procedures as high-volume specialist centers,
where overall satisfaction levels are high.
The researchers said the study did not find a cause-and-effect
relationship between lower income and dissatisfaction with
knee-replacement surgery, but said the association was
"It is certainly possible, based on our results, that socioeconomic factors -- particularly household income -- may be strongly associated with satisfaction and functional results," they said. "Future studies should be directed to determining the causes of this association, and if further studies do, in fact, confirm this hypothesis, then studies of clinical results after total knee [replacement] should consider stratifying patients by socioeconomic status."
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