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Expectation and Outlook: The Impact of Patient Preference on Arthritis Care Among African Americans

Figaro, M. Kathleen MD; Williams-Russo, Pamela MD, MPH; Allegrante, John P. PhD


We investigated beliefs of blacks with osteoarthritis (OA) regarding total knee replacement (TKR) surgery. These beliefs potentially related to the known racial disparity in the use of TKR. Ninety-four community-dwelling blacks aged 50 to 89 with knee OA in Harlem, NY, were assessed for arthritis knowledge, expectations, quality of life (QoL), and disability. Subjects have had OA for a median of 6 years and the disability was severe. Only 36% believed that TKR was likely to improve knee pain; 45% stated that TKR would not improve their current health. Mean QoL was 7.6 ± 1.7 (max 10). Despite debilitating OA, African American patients perceive a high QoL, yet have low expectations from TKR and are therefore less likely to consider TKR as a treatment for OA.

Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn (Dr Figaro); the Robert Wood Johnson Foundation, Princeton, NJ (Dr Williams-Russo); and the Department of Health and Behavior Studies, Teachers College, Joseph L. Mailman School of Public Health, Columbia University, and National Center for Health Education, New York, NY (Dr Allegrante).

Corresponding author: M. Kathleen Figaro, MD, MS, Department of Medicine, Vanderbilt University Medical Center/GRECC, 1310 24th Ave S, RM 4B111, Nashville, TN 37212 (e-mail:

This study was supported by a National Research Service Award, Agency for Health Research and Quality, and the Cornell Center for Aging Research and Clinical Care.

© 2005 Lippincott Williams & Wilkins, Inc.