Amen Troy B, Chatterjee Abhinaba, Rudisill Samuel S, Joseph Gabriel P, Nwachukwu Benedict U, Ode Gabriella E, Williams Riley J
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York, USA.
Orthop J Sports Med. 2023 Aug 16;11(8):23259671231187447. doi: 10.1177/23259671231187447. eCollection 2023 Aug.
Racial and ethnic disparities in the field of orthopaedic surgery have been reported extensively across many subspecialties. However, these data remain relatively sparse in orthopaedic sports medicine, especially with respect to commonly performed procedures including knee and hip arthroscopy.
To assess (1) differences in utilization of knee and hip arthroscopy between White, Black, Hispanic, and Asian or Pacific Islander patients in the United States (US) and (2) how these differences vary by geographical region.
Descriptive epidemiology study.
The study sample was acquired from the 2019 National Ambulatory Surgery Sample database. Racial and ethnic differences in age-standardized utilization rates of hip and knee arthroscopy were calculated using survey weights and population estimates from US census data. Poisson regression was used to model age-standardized utilization rates for hip and knee arthroscopy while controlling for several demographic and clinical variables.
During the study period, rates of knee arthroscopy utilization among White patients were significantly higher than those of Black, Hispanic, and Asian or Pacific Islander patients (ie, per 100,000, White: 180.5, Black: 113.2, Hispanic: 122.2, and Asian: 58.6). Disparities were even more pronounced among patients undergoing hip arthroscopy, with White patients receiving the procedure at almost 4 to 5 times higher rates (ie, per 100,000, White: 12.6, Black: 3.2, Hispanic: 2.3, Asian or Pacific Islander: 1.8). Disparities in knee and hip arthroscopy utilization between White and non-White patients varied significantly by region, with gaps in knee arthroscopy being most pronounced in the Midwest (adjusted rate ratio, 2.0 [95% CI, 1.9-2.1]) and those in hip arthroscopy being greatest in the West (adjusted rate ratio, 5.3 [95% CI, 4.9-5.6]).
Racial and ethnic disparities in the use of knee and hip arthroscopy were found across the US, with decreased rates among Black, Hispanic, and Asian or Pacific Islander patients compared with White patients. Disparities were most pronounced in the Midwest and South and greater for hip than knee arthroscopy, possibly demonstrating emerging inequality in a rapidly growing and evolving procedure across the country.
骨科手术领域的种族和民族差异在许多亚专业中都有广泛报道。然而，这些数据在骨科运动医学中仍然相对较少，尤其是在包括膝关节和髋关节镜检查在内的常见手术方面。
评估（1）美国白人、黑人、西班牙裔和亚裔或太平洋岛民患者在膝关节和髋关节镜检查使用方面的差异，以及（2）这些差异如何因地理区域而异。
描述性流行病学研究。
研究样本取自2019年国家门诊手术样本数据库。使用调查权重和美国人口普查数据中的人口估计数，计算髋关节和膝关节镜检查年龄标准化使用率的种族和民族差异。采用泊松回归模型对髋关节和膝关节镜检查的年龄标准化使用率进行建模，同时控制几个人口统计学和临床变量。
在研究期间，白人患者膝关节镜检查的使用率显著高于黑人、西班牙裔和亚裔或太平洋岛民患者（即每10万人中，白人：180.5，黑人：113.2，西班牙裔：122.2，亚裔：58.6）。髋关节镜检查患者之间的差异更为明显，白人患者接受该手术的比率几乎高出4至5倍（即每10万人中，白人：12.6，黑人：3.2，西班牙裔：2.3，亚裔或太平洋岛民：1.8）。白人和非白人患者在膝关节和髋关节镜检查使用上的差异因地区而异，膝关节镜检查的差距在中西部最为明显（调整后的率比，2.0 [95%置信区间，1.9 - 2.1]），髋关节镜检查的差距在西部最大（调整后的率比，5.3 [95%置信区间，4.9 - 5.6]）。
在美国各地发现了膝关节和髋关节镜检查使用方面的种族和民族差异，与白人患者相比，黑人、西班牙裔和亚裔或太平洋岛民患者的使用率较低。差异在中西部和南部最为明显，髋关节镜检查的差异大于膝关节镜检查，这可能表明在全国迅速发展和演变的手术中出现了新的不平等现象。
