A Decade of Racial Trends in Unicompartmental Knee Arthroplasty Utilization

The authors sought to examine the racial trends of relative unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) utilization and complications over 10 years. The National Surgical Quality Improvement Program (NSQIP) database was utilized from 2010 to 2020. Adjusted incidence rate ratios (IRR) were derived for UKA:TKA among African American (AA), Asian, American Indian (AI), and Caucasian racial groups. Multivariate regression was used to compare complications; 406,684 patients were included. AA and AI patients underwent UKA at a lower rate than Caucasian patients (IRR = 0.42, 0.48, respectively, p < 0.001), while Asian patients underwent UKA at a higher rate (IRR = 1.4, p < 0.001). From 2010 to 2020, the IRR among AA patients decreased from 0.71 to 0.57 (p < 0.001), and the IRR for Asian patients increased from 0.38 to 2.07 (p < 0.001). There were no differences in complications. In conclusion, racial disparities in UKA utilization have widened over the past decade, despite similar rates of short-term complications after UKA. Level of Evidence: Prognostic – III. (Journal of Surgical Orthopaedic Advances 34(4):207–210, 2025)

Key words: disparities, race utilization, access, outcomes, arthroplasty, unicondylar