Spotlight on Research for 2003

January 2003 (historical)

Social Experience Seen to Influence Joint Replacement Decisions

By Katie Lai

When people think about having a hip or knee replaced, knowing someone who's had the surgery may influence their decision.

Past studies have shown that in certain minority populations, joint replacement is underutilized for treating pain and improving function. Now, a recent study funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the Robert Wood Johnson Foundation has shown that one reason African Americans may be less likely than Caucasians to seek joint replacement surgery is because they know fewer people who have had the procedure.

Mary Charlson, M.D., and her research team at Cornell University conducted a 30-minute telephone survey of hip and knee pain and joint replacement surgery in 515 African Americans and 455 Caucasians. According to the results, 42 percent of African Americans and 31 percent of Caucasians reported pain. However, 42 percent of African Americans--compared with 65 percent in the Caucasian group--knew someone who had surgery for the pain. This racial difference in personal contacts with joint surgery recipients may contribute to underutilization of the procedure in African Americans.

For many people, joint surgery helps relieve the pain and disability of severe osteoarthritis. This is the most common type of arthritis that affects millions of people in the United States. In osteoarthritis, the surface layer that cushions cartilage in a joint breaks down and wears away, allowing bones under the cartilage to rub together, resulting in pain, swelling, and loss of joint motion.


Blake VA, Allegrante JP, Robbins L, Mancuso CA, Peterson MGE, Esdaile JM, Paget SA, Charlson ME. Racial differences in social network experience and perceptions of benefit of arthritis treatments among New York City Medicare beneficiaries with self-reported hip and knee pain. Arthritis & Rheumatism 2002;47(4):366-371.