{"id":19734,"date":"2024-06-06T09:36:54","date_gmt":"2024-06-06T13:36:54","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=19734"},"modified":"2024-06-06T09:36:57","modified_gmt":"2024-06-06T13:36:57","slug":"association-between-immigration-status-and-total-knee-arthroplasty-outcomes","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-immigration-status-and-total-knee-arthroplasty-outcomes\/","title":{"rendered":"Association between immigration status and total knee arthroplasty outcomes in Ontario, Canada: a population-based matched cohort study"},"content":{"rendered":"<p><strong class=\"sub-title\">Background<\/strong> \u2014 Immigrants and refugees face unique challenges navigating the health care system to manage severe arthritis, because of unfamiliarity, lack of awareness of surgical options, or access. The purpose of this study was to assess total knee arthroplasty (TKA) uptake, surgical outcomes, and hospital utilization among immigrants and refugees compared with Canadian-born patients.<\/p>\n<p><strong class=\"sub-title\">Methods<\/strong>\u00a0\u2014\u00a0We included all adults undergoing primary TKA from January 2011 to December 2020 in Ontario. Cohorts were defined as Canadian-born or immigrants and refugees. We assessed change in yearly TKA utilization for trend. We compared differences in 1-year revision, infection rates, 30-day venous thromboembolism (VTE), presentation to emergency department, and hospital readmission between matched Canadian-born and immigrant and refugee groups.<\/p>\n<p><strong class=\"sub-title\">Results <\/strong>\u2014 We included 158 031 TKA procedures. A total of 11 973 (7.6%) patients were in the immigrant and refugee group, and 146 058 (92.4%) patients were in the Canadian-born group. The proportion of TKAs in Ontario performed among immigrants and refugees nearly doubled over the 10-year study period (<i>p<\/i>\u00a0&lt; 0.001). After matching, immigrants were at relatively lower risk of 1-year revision (0.9% v. 1.6%,\u00a0<i>p<\/i>\u00a0&lt; 0.001), infection (<i>p<\/i>\u00a0&lt; 0.001), death (<i>p<\/i>\u00a0= 0.004), and surgical complications (<i>p<\/i>\u00a0&lt; 0.001). No differences were observed in rates of 30-day VTE or length of hospital stay. Immigrants were more likely to be discharged to rehabilitation (<i>p<\/i>\u00a0&lt; 0.001) and less likely to present to the emergency department (<i>p<\/i>\u00a0&lt; 0.001) than Canadian-born patients.<\/p>\n<p><strong class=\"sub-title\">Conclusion <\/strong>\u2014 Compared with Canadian-born patients, immigrants and refugees have favourable surgical outcomes and similar rates of resource utilization after TKA. We observed an underutilization of these procedures in Ontario relative to their proportion of the population. This may reflect differences in perceptions of chronic pain or barriers accessing arthroplasty.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Immigrants and refugees face unique challenges navigating the health care system to manage severe arthritis, because of unfamiliarity, lack of awareness of surgical options, or access. The purpose of this study was to assess total knee arthroplasty (TKA) uptake, surgical outcomes, and hospital utilization among immigrants and refugees compared with Canadian-born patients. Methods\u00a0\u2014\u00a0We [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[19,51,18,25],"migration-helper-qa-sample-set":[],"class_list":["post-19734","journal_article","type-journal_article","status-publish","hentry","topic-marginalized-populations","topic-musculoskeletal-diseases-and-disorders","topic-racialized-communities","topic-surgery"],"acf":{"citation":"Lex JR, Pincus D, Paterson MJ, Widdifield J, Chaudhry H, Fowler R, Hawker G, Ravi B. <em>Can J Surg<\/em>. 2024; <span class=\"cit\">67(3): E228-35. Epub 2024 May 10.<\/span>","source_url":"https:\/\/doi.org\/10.1503\/cjs.013723","ices_scientist":[1102,1100,1122,1234,1267,1333],"site":[6733],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association between immigration status and total knee arthroplasty outcomes in Ontario, Canada: a population-based matched cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Immigrants and refugees face unique challenges navigating the health care system to manage severe arthritis, because of unfamiliarity, lack\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" 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