Racial disparities in total knee replacement among Medicare enrollees--United States, 2000-2006.

An estimated 45% of U.S. adults might be at risk for developing symptomatic knee osteoarthritis during their lifetimes, with whites and blacks at equal risk for this common disabling condition. Total knee replacement (TKR) is an effective method of reducing pain and improving physical function among those with disabling knee osteoarthritis; however, whites have been more likely to undergo the procedure than blacks. As a result, a Healthy People 2010 objective calls for eliminating racial disparities in the rate of TKR among persons aged >/=65 years. To monitor progress toward achieving this objective, CDC analyzed national and state TKR rates for Medicare enrollees for the period 2000-2006, stratified by sex, age group, and black or white race. From 2000 to 2006, the TKR rate overall in the United States increased 58%, from 5.5 to 8.7 per 1,000 population, with similar increases among whites (61%) and blacks (56%). However, the TKR rate for blacks was 37% lower than the rate for whites in 2000 (3.6 versus 5.7 per 1,000 population) and 39% lower in 2006 (5.6 versus 9.2 per 1,000 population). Health-care providers and public health agencies might help reduce this disparity by widely distributing TKR information that is tailored to the education and literacy levels and culture of patients with symptomatic knee osteoarthritis. Health-care providers should conduct, as routine practice, thorough discussions regarding knee pain symptoms and loss of physical function with older patients of all races who might be candidates for TKR.