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Fear in Arthroplasty Surgery: The Role of Race

  • Symposium: Papers Presented at the Hip Society Meetings 2009
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Understanding the difference in perceived functional outcomes between whites and blacks and the influence of anxiety and pain on functional outcomes after joint arthroplasty may help surgeons develop ways to eliminate the racial and ethnic disparities in outcome. We determined the difference in functional outcomes between whites and blacks and assessed the influence of fear and anxiety in total joint arthroplasty outcomes in 331 patients undergoing primary hip and knee arthroplasty. WOMAC, Quality of Well Being, SF-36, and Pain and Anxiety Symptoms Scale (PASS) were administered pre- and postoperatively (average 5-year followup). For the SF-36 General Health Score, blacks reported having worse perceived general health than whites before surgery. Regardless of time, blacks scored worse than whites for all measures except for the SF-36 physical function and general health scores. Blacks had a greater fear score (ie, that associated with the procedure) and total PASS score. For both races, there was a low association between the fear dimensions and dependent measures before and after surgery. Black patients undergoing hip and knee arthroplasty had lower scores than whites in most outcome measures regardless of time of assessment. We found higher fear levels before joint arthroplasty in blacks compared with whites. After surgery, blacks had much higher associations of the fear subscale, cognitive subscale, and total PASS score with the WOMAC physical function, pain, and total scores.

Level of Evidence: Level II, prospective controlled cohort study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Dr Arturo Corces and Dr Roland Prichard for their contributions to this project.

Author information

Authors and Affiliations

  1. Orthopaedic Institute at Mercy Hospital, 3659 South Miami Avenue, Suite 4008, Miami, FL, 33133, USA

    Carlos J. Lavernia MD

  2. Arthritis Surgery and Research Foundation Inc, Miami, FL, USA

    Jose C. Alcerro MD

  3. Florida International University, Miami, FL, USA

    Mark D. Rossi PhD, PT, CSCS

Authors
  1. Carlos J. Lavernia MD
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  2. Jose C. Alcerro MD
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  3. Mark D. Rossi PhD, PT, CSCS
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Corresponding author

Correspondence to Carlos J. Lavernia MD.

Additional information

One or more of the authors (CJL) have received funding from Mercy Hospital, Miami, FL; Arthritis Surgery Research Foundation, Inc, Miami, FL; and Zimmer, Inc, Warsaw, IN.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Orthopaedic Institute at Mercy Hospital, Miami, FL, USA.

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Lavernia, C.J., Alcerro, J.C. & Rossi, M.D. Fear in Arthroplasty Surgery: The Role of Race. Clin Orthop Relat Res 468, 547–554 (2010). https://doi.org/10.1007/s11999-009-1101-6

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  • DOI: https://doi.org/10.1007/s11999-009-1101-6

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