Mehta Bella, Szymonifka Jackie, Dey Shirin, Navarro-Millan Iris, Grassia Stephen, Mandl Lisa A, Bass Anne R, Russell Linda, Parks Michael, Figgie Mark, Lee Lily, Nguyen Joe, Goodman Susan M
Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA.
Weill Cornell Medicine, New York, USA.
BMC Musculoskelet Disord. 2019 Feb 9;20(1):67. doi: 10.1186/s12891-019-2446-y.
Community characteristics such as poverty affect total knee arthroplasty (TKA) outcomes. However, it is unknown whether other community factors such as immigrant proportion (IP) also affect outcomes. Our objective was to determine the association of neighborhood IP on preoperative (pre-op) and 2-year postoperative (post-op) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function after elective TKA.
Patients in a high volume institutional TKA registry between May 2007 and February 2011 were retrospectively analyzed. Demographics, pre-op and 2-year post-op WOMAC pain and function scores, and geocodable addresses were obtained. Patient-level variables were linked to US Census Bureau census tract data. The effect of patient and neighborhood-level factors on WOMAC scores were analyzed using linear mixed effects models.
3898 TKA patients were analyzed. Pre-op and 2-year post-op WOMAC pain and function scores were between 2.75-4.88 WOMAC points worse in neighborhoods with a high IP (≥ 40%) compared to low IP (< 10%). In multivariable analyses, these differences were not statistically significant. Women had worse pre-op and 2-year post-op WOMAC scores (all p ≤ 0.04), but this difference was not influenced by neighborhood IP (all p NS).
Patients living in high (≥40%) IP neighborhoods do not have worse pre-op or 2-year post-op pain and function outcomes after TKA compared to those living in low (< 10%) IP neighborhoods. Although sex differences favoring males are notable, these differences are not associated with IP. High neighborhood IP do not appear to affect outcomes after TKA.
贫困等社区特征会影响全膝关节置换术（TKA）的疗效。然而，移民比例（IP）等其他社区因素是否也会影响疗效尚不清楚。我们的目的是确定社区IP与择期TKA术前（术前）和术后2年的西安大略和麦克马斯特大学骨关节炎指数（WOMAC）疼痛及功能之间的关联。
对2007年5月至2011年2月期间大量机构TKA登记处的患者进行回顾性分析。获取人口统计学资料、术前和术后2年的WOMAC疼痛及功能评分以及可地理编码的地址。将患者层面的变量与美国人口普查局的普查区数据相联系。使用线性混合效应模型分析患者和社区层面因素对WOMAC评分的影响。
分析了3898例TKA患者。与低IP（<10%）社区相比，高IP（≥40%）社区的术前和术后2年WOMAC疼痛及功能评分要差2.75 - 4.88个WOMAC点。在多变量分析中，这些差异无统计学意义。女性术前和术后2年的WOMAC评分更差（所有p≤0.04），但这种差异不受社区IP的影响（所有p无统计学意义）。
与生活在低IP（<10%）社区的患者相比，生活在高IP（≥40%）社区的患者在TKA术后的术前或术后2年疼痛及功能结局并不更差。尽管有利于男性的性别差异显著，但这些差异与IP无关。高社区IP似乎不会影响TKA术后的疗效。
