Lower education levels associated with poorer TKA outcomes — 6 insights


A study, published in Arthritis Care & Research, examined whether education levels affect total knee arthroscopy outcomes.

Susan Goodman, MD, of New York City-based Hospital for Special Surgery, and colleagues used patient level variables from an institutional registry and linked them to U.S. Census Bureau data. They constructed statistical models on a multilevel framework including patient and CT levels. They then used linear mixed effect models with random intercepts to assess the interaction between education and poverty.

Researchers examined 3,970 TKA patients.

Here's what you should know:

1. Of the patient base, 2,438 had some college education or more.

2. Researchers found patients with no college education had worse pain and function at baseline and at a two-year follow up.

3. Living in a neighborhood that's more than 20 percent below the poverty line was associated with worse two-year pain scores and function.

4. Researchers found a strong interaction between individual education levels and community poverty with WOMAC scores at two years.

5. Patients without college education in poor communities had pain scores around 10 points worse than individuals with some college experience.

6. Patients with college experience in wealthy communities had a one point difference in pain scores, while function scores were similar when compared to patients without college experience in poor communities.

Researchers concluded, "In poor communities, those without college attain two-year WOMAC scores that are 10 points worse than those with some college; education has no impact on TKA outcomes in wealthy communities. How education protects those in impoverished communities warrants further study."

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