Shared Decision-Making in Total Hip and Knee Arthroplasty: Understanding Surgeon and Patient Perspectives Regarding When It Is Time for Surgery.

Background: Although total hip and total knee arthroplasty are highly successful operations, the decision of whether and when to undergo surgery is highly subjective and discretionary, and specific guidelines regarding readiness for surgery remain elusive. The nature of these decisions underscores the importance of shared decision-making, which is founded on the concept that patients substantially contribute to determining their own readiness for surgery. The OPTION survey was developed as a conversation aid to facilitate shared decision-making in the context of total joint arthroplasty.

Association of Geographic Social Vulnerability With Race-Based Differences in the Utilization of Total Hip Arthroplasty Surgeries for Medicare Beneficiaries.

Background: Racial disparities exist in the utilization of total hip arthroplasties (THAs). The social vulnerability index (SVI), which measures geographic-level disadvantage and includes themes, such as socioeconomic status, minority status, and language, may partially explain disparities in THA use. Our objectives were to determine the association of the composite SVI with THA use for (1) White Medicare beneficiaries, (2) Black Medicare beneficiaries, and (3) the difference in THA use between White and Black beneficiaries.

Patient-Physician Racial Concordance Increases Likelihood of Total Knee Arthroplasty Recommendation.

Background: Minority patients have been shown to underutilize total knee arthroplasty (TKA) compared to non-Hispanic White patients. Specific drivers of this underutilization have not been identified. We sought to determine if racial concordance between patient and physician is associated with the surgeon's likelihood to recommend TKA.

Developing a Novel Surgical Care Access Score for Patients With Osteoarthritis Considering Total Knee Replacement.

Objective: Access to specialized orthopedic care is an important determinant of the decision to undergo total knee replacement (TKR); however, most studies have mainly used distance to the nearest high-volume hospital as the primary proxy for access. We applied the two-step floating catchment area (2SFCA) method to develop a more comprehensive TKR access score that accounts for other potential factors (ie, supply of and demand for this procedure) that also affect access.

Methods: To apply the 2SFCA method, we first estimated TKR demand using the Centers for Disease Control and Prevention estimates of prevalence of osteoarthritis, which were multiplied by estimates of patients who would potentially benefit from TKR.

Risk of significant functional impairment across cancer diagnosis and care continuum.

Background: The authors examined baseline physical functional (PF) impairment among cancer outpatients in the National Cancer Institute Cancer Moonshot study Northwestern University Improving the Management of Symptoms During and Following Cancer Treatment (NU IMPACT). They hypothesized that PF impairment, measured with the Patient Reported Outcome Measurement Information System-Physical Function (PROMIS-PF) survey, would (1) be common and more prevalent for patients receiving treatment compared with no treatment and (2) differ across tumor types, independent of cancer continuum phase.

Methods: Adults who were diagnosed with cancer in NU IMPACT (n = 2273) were sampled, and their PROMIS-PF scores were compared across tumor types and cancer continuum (curative, noncurative, or no treatment), with scores ≤40 indicating moderate-severe impairment.