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Language-Concordant Preoperative Education Is Associated With Reduced Readmission Rates after Total Knee
Oluwatofunmi Jummie Akinwunmi1, Wyatt H Buchalter2, Nattaly E Greene2
1Vagelos College of Physicians of Surgeons, Columbia University, New York, New York.
The Journal of Arthroplasty
|June 18, 2026
Summary
A Spanish-speaking nurse educator significantly reduced readmissions for patients undergoing total knee arthroplasty (TKA). This intervention also improved postoperative pain scores for this patient group.
Area of Science:
- Orthopedic Surgery
- Health Services Research
- Health Equity
Background:
- Language barriers negatively impact surgical patient satisfaction and care quality.
- Preoperative education's effect on disparities for non-English speakers is not well understood.
- A Spanish-speaking nurse educator was implemented for preoperative education in hip and knee arthroplasty.
Purpose of the Study:
- To evaluate the impact of a language-concordant nurse educator on readmission rates.
- To compare outcomes for Spanish-speaking versus English-speaking patients undergoing total knee arthroplasty (TKA).
Main Methods:
- Retrospective, single-center cohort study of 1,381 TKA surgeries (2022-2024).
- Compared 30- and 90-day readmission rates using difference-in-differences (DiD) analysis.
- Adjusted for patient demographics and surgical factors using multivariable logistic regression.
Main Results:
- Spanish-speaking patients initially had higher readmission odds (OR=12.6 for 30-day, OR=6.25 for 90-day).
- Post-intervention, readmissions decreased significantly for Spanish-speaking patients (DiD OR=0.11 for 30-day, DiD OR=0.18 for 90-day).
- Improved Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores observed (DiD Beta = -40 points).
Conclusions:
- Implementing a language-concordant nurse educator reduced TKA readmissions for Spanish-speaking patients.
- The intervention also led to better postoperative pain outcomes.
- Language-concordant care can mitigate disparities in surgical outcomes.