While success rates for total knee replacement, or arthroplasty, has improved due to advancements in surgical techniques and better implant designs, complications can lead to transfemoral amputations. Although racial disparities have been reported in the utilization of knee replacement surgery, and in the rates and level of amputations from vascular causes, racial disparities have not been studied with respect to transfemoral amputations resulting from complications of the knee replacement. A team of researchers from the Cleveland Clinic, Ohio, and Case Western Reserve University has now found that certain populations, including black men and patients older than 80 years and younger than 50 years, had higher rates of amputation after failure of a total knee replacement. The study was published in the July issue of Clinical Orthopaedics and Related Research.
Using National Inpatient Sample data, the researchers found that 9,733 transfemoral amputations between 2000 and 2011 were the result of complications from the surgery. Standardized rates of amputation were also calculated for different age and gender racial groups by dividing the number of transfemoral amputations in each group with the corresponding number of total knee arthroplasties and adjusting for demographics and comorbidities.
The team found evidence of racial disparities in amputation rates following a total knee replacement—particularly for black men, who had the highest rate of amputation, at 578 per 100,000 total knee replacement surgeries. Black women and white men followed; white women had the lowest rate of post-surgery amputation.
The study’s authors stressed the need for more research to understand the reasons for these disparities and what measures should be taken to eliminate them.