Clinical Orthopaedics and Related Research: May 2013 - Volume 471 - Issue 5 - p 1451–1457 doi: 10.1007/s11999-012-2776-7 Symposium: Special Considerations for TKA in Asian Patients

Comparative Demographics, ROM, and Function After TKA in Chinese, Malays, and Indians

Siow, Wei, Ming, MBBS, MRCS1, a; Chin, Pak, Lin, MBBS, FRCS1; Chia, Shi, Lu, MBBS, FRCS1; Lo, Ngai, Nung, MBBS, MRCS1; Yeo, Seng, Jin, MBBS, FRCS1

Background There is marked racial disparity in TKA use rates, demographics, and outcomes between white and Afro-Caribbean Americans. Comparative studies of ethnicity in patients undergoing TKAs have been mostly in American populations with an underrepresentation of Asian groups. It is unclear whether these disparities exist in Chinese, Malays, and Indians.


Questions/purposes We therefore determined whether (1) TKA use; (2) demographics and preoperative statuses; and (3) functional outcomes at 2 years after TKA differed among three ethnic groups, namely, Chinese, Malays, and Indians who underwent TKA.


Methods From our hospital joint registry we identified 5332 patients who had a primary TKA from 2004 to 2009. The cohort was stratified by race and subsequently compared for demographics, preoperative knee ROM, and deformity. At the second postoperative year we determined Knee Society scores, Oxford knee scores, and obtained SF-36 health questionnaires.


Results Six percent more Chinese patients underwent TKAs compared with Malays or Indians. Malays were operated on at a younger age with a higher body mass index. Chinese patients had more severe preoperative varus deformity. There were no major differences in joint ROM in all races. For Knee Society, Oxford knee, and SF-36 scores, Chinese patients had consistently higher preoperative and postoperative scores. Malays presented with the lowest preoperative scores but had the greatest improvement in scores at followup with postoperative scores similar to Chinese counterparts. Indians had the lowest postoperative scores and worst improvement of all


Conclusions The variations in demographics, preoperative statuses, and subsequent postoperative outcomes between the races should be considered when comparing TKA outcome studies in Asian populations.


Level of Evidence Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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