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Underutilization of Hand Corticosteroid Injections and Arthroplasty for Minority Demographics
Christopher M Dussik1, Amy Phan1, Akhil Dondapati1
1Department of Orthopaedic Surgery, University of Rochester School of Medicine, Rochester, NY.
Purpose:
The management of hand osteoarthritis is a cornerstone of hand surgery practice. Corticosteroid injections and surgical interventions form the mainstay of treatment for those patients with symptoms recalcitrant to less-invasive measures. Health care disparities have been increasingly recognized, particularly regarding variations in pain management. This study aimed to determine whether such disparities exist across different racial and ethnic groups in the treatment of hand osteoarthritis.
Methods:
We used the TriNetX database to evaluate patients diagnosed with hand osteoarthritis between January 1, 2010 and December 31, 2024. Diagnostic and billing codes were used to identify patients, assess overall health care utilization postdiagnosis, and gauge the use of corticosteroid injections and surgical intervention across different demographics. Outcomes were stratified based on racial and ethnic identification. Matching was performed to mitigate risk for confounding. Odds ratios were used to describe differences in the probability of receiving treatment across groups of interest.
Results:
A total of 896,636 patients diagnosed with hand osteoarthritis were identified. Non-Hispanic White patients had nearly twice the odds of undergoing corticosteroid injections and demonstrated consistently higher rates of surgical treatment compared with minority populations across unmatched analyses. After matching for demographic and comorbidity variables, these disparities largely persisted despite similar overall health care utilization.
Conclusions:
Minority demographics have lower odds of receiving corticosteroid injections for the treatment of hand osteoarthritis. Similarly, these groups undergo surgical management at considerably lower rates. These findings highlight the persistent disparities in treatment faced by underrepresented groups and underscore the critical importance of considering social determinants of health in the management of upper extremity conditions.
Type Of Study/Level Of Evidence:
Prognosis IIC.
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