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Knee Surgery Outcomes Worse with Low Education

Reuters reports that patients who live in low-income communities and lack a college education may have worse pain after knee replacement surgery than their more educated neighbors, citing results from a recent study from the Hospital for Special Surgery in NY.  (Citation source:

The study included 3,790 knee replacement (TKA), of whom 61% had some college eduction.  No college education was associated with worse pain and function at baseline and 2 years after TKA (p = 0.0001).

Living in a poor neighborhood (>20% below poverty) was associated with worse 2-year pain (p = 0.02) and function (p = 0.006). There was a strong interaction between individual education and community poverty with WOMAC scores at two years.

The effects were additive such that those college and living in poor communities had pain scores that were ~10 points worse than those with some college (83.4% vs. 75.7%, p < 0.0001); in wealthy communities, college was associated with one point difference in pain.

Many patients without any college lived in poor neighborhoods and in communities where a college education was less common. There wasn’t a meaningful association between pain levels and the overall level of education in the community, researchers reported in Arthritis Care and Research.

The author has no conflicts of interest to disclose related to this subject

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