Total Knee Arthroplasty: Socioeconomic Disparities of Post-Operative Complications

Total knee arthroplasty (TKA) is one of the most performed orthopedic operations in the United States. Current projections are that by 2030, there will be 935,000 primary TKAs annually.1 Given the growing prevalence of this surgical procedure, it is important to evaluate the associated rate of morbidities and mortality. The Centers for Medicare and Medicare Services (CMS) reports the following TKA postoperative complications: strokes, deep vein thrombosis/blood clots, wound dehiscence, pressure sores, etc. It is widely understood that socioeconomic disparities can play a role in postoperative complications, but the extent to which these disparities affect health outcomes varies largely from region to region as well as from one surgery to another. For this reason and the growing prevalence of TKA, we are analyzing socioeconomic disparities in Florida and to what extent these disparities may be affecting health outcomes. Hardee County, a known health professional shortage area, and Osceola County had significantly higher complication rates compared to higher average income counties-Orange, Miami-Dade, Alachua, Lake and Collier. The middle-income counties were further analyzed to determine where the threshold of significance of complication rates becomes apparent. These staggering discrepancies highlight the need to identify complications of this surgery, their causes, and overall disparities among rural/low-income patient populations.