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Unpublished Paper
Differential burden of musculoskeletal pain in African Americans and whites patients at the time of total joint replacement surgery
Orthopedics and Physical Rehabilitation Publications and Presentations
  • Leslie R. Harrold, University of Massachusetts Medical School
  • Anthony Porter, University of Massachusetts Medical School
  • Philip C. Noble, Baylor College of Medicine
  • David C. Ayers, University of Massachusetts Medical School
  • Jeroan J. Allison, University of Massachusetts Medical School
  • Patricia D. Franklin, University of Massachusetts Medical School
UMMS Affiliation
Department of Orthopedics and Physical Rehabilitation; Department of Quantitative Health Sciences
Publication Date
3-30-2017
Document Type
Article Preprint
Abstract

Objective: African Americans patients have greater operative joint pain and functional limitation at the time of total joint replacement (TJR) compared to white patients. We examined the factors associated with this apparent disparity.

Methods: A consecutive sample of 5745 patients with advanced knee and hip osteoarthritis [who elected to undergo TJR in 2011-201] reported, preoperatively, medical comorbidities, operative and non-operative hip/ knee pain using Hip and Knee Disability and Osteoarthritis Outcome Scores (HOOS/KOOS), function using Short Form 36 Physical Component Score (PCS). Total burden of musculoskeletal pain was quantified as moderate/severe pain in non-operative hip and knee joints and lumbar back pain using Oswestry Disability Index (ODI). Associations among race, medical co-morbidites (modified Charlson), total musculoskeletal pain burden, operative joint pain, and functional limitations were examined using multivariable regression models.

Results:Compared to Whites, African Americans (143 hips and 201 knees) reported worse surgical joint pain (mean pain: 39.3 vs. 49.2 [hip]; 43.4 vs. 53.2 [knee]), poorer surgical joint function (mean function: 38.9 vs. 45.7 [hip]; 45.9 vs. 53.4 [knee]), poorer global function (mean PCS: 30.0 vs. 31.6 [hip]; 31.3 vs. 33.1 [knee]), and more non-operative joints pain (p

Conclusions: Greater burden of musculoskeletal pain explains differences in pre-operative pain and function between African American and white patients and likely impacts rehabilitation and subsequent TJR outcomes.

Keywords
  • total joint replacement (TJR),
  • musculoskeletal pain,
  • rehabilitation,
  • African Americans,
  • Whites,
  • health disparities
Rights and Permissions
Copyright © 2017 The Author(s).
Comments

This article is a preprint and has not been peer-reviewed.

This work is funded in part by a grant (P50HS018910) from the Agency for Healthcare Research and Quality and by a grant from the Gladden Society.

Creative Commons License
Creative Commons Attribution 4.0
Citation Information
Leslie R. Harrold, Anthony Porter, Philip C. Noble, David C. Ayers, et al.. "Differential burden of musculoskeletal pain in African Americans and whites patients at the time of total joint replacement surgery" (2017)
Available at: http://works.bepress.com/jeroan_allison/252/