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Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Health Disparities

Background:

  • Racial disparities in total knee arthroplasty (TKA) utilization and pain management exist between African American and Caucasian patients.
  • Limited data exists on racial differences in perioperative pain management following TKA for knee osteoarthritis.

Purpose of the Study:

  • To investigate racial differences in perioperative pain management among African American and Caucasian patients undergoing primary TKA.
  • To compare pain scores, opioid consumption, and refill rates between racial groups.

Main Methods:

  • Retrospective study of 804 African American patients undergoing primary TKA (2013-2022).
  • Matched 2:1 with Caucasian patients based on ASA score, age, gender, and BMI.
  • Evaluated demographic data and perioperative variables: pain scores, morphine equivalents, operative time, length of stay, and opioid refills.

Main Results:

  • African American patients had higher preoperative pain scores and greater opioid use preoperatively and postoperatively.
  • A significantly higher proportion of African American patients received opioid prescriptions and refills within 90 days pre- and post-operatively.
  • African American patients received significantly less intraoperative opioid medication.

Conclusions:

  • Significant racial differences in perioperative pain management were observed after TKA.
  • The underlying reasons for these disparities require further investigation.
  • Standardized pain management protocols, including opioid guidelines, should be implemented for all TKA patients regardless of race.