Study Highlights Racial Disparities in Knee OA Treatment

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Black patients with knee osteoarthritis have worse outcomes than their white counterparts, shows a new study.

“We found that African Americans with knee osteoarthritis had poorer scores on the physical function tests than Caucasians,” said study co-author Kelli Allen, Ph.D., a rheumatology researcher with the University of North Carolina School of Medicine.

Her study included 322 patients (72% women, 22% black, mean ± SD age 66 ± 11 years, mean ± SD body mass index (BMI) 31 ± 8 kg/m2). On average, black patients in the trial tended to be younger, single, and female, while also having more pain, fear of movement, and a higher BMI compared with whites.

Study participants completed three common physical function tests: the 2-minute step (2MST), timed-up-and-go, and 30-second chair stand (30s-CST), with data subsequently adjusted for demographic, socioeconomic, psychological, and physical health.

Black study participants were more than twice as likely to have poor 30-second chair stand and 2-minute step exam outcomes (30-second chair stand odds ratio 2.79 [95% CI 1.65-4.72]; 2-minute step exam odds ratio 2.37 [95% CI 1.40-4.03], and roughly 70% more likely to have poor exam outcomes (odds ratio 3.71 [95% CI 2.16-6.36]).

The differences persisted after adjusting for demographic and psychological variables—an unexpected finding, study authors wrote, given that these covariates are known risk factors for poor function. However, the results were attenuated when adjusting for physical health and socioeconomic factors.

“Results of this study highlight the existence of health disparities, particularly in the area of knee osteoarthritis, and the importance of continuing to understand and address these disparities,” Dr. Allen said.

Study authors concluded that lower function was associated with physical inactivity—a major concern given the importance of exercise in managing osteoarthritis and improving function.

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REFERENCE

Flowers PPE, Allen KD, Schwartz TA. Racial Differences in Performance-Based Function and Potential Explanatory Factors Among Individuals With Knee Osteoarthritis. Arthritis Care & Research. 2020; 72(9): 1196-1204. DOI 10.1002/acr.24018