Comparing Severity of Knee Arthritis at an Urban Center by Insurance Type Prior to Total Knee Arthroplasty

This study compares radiographic osteoarthritis severity prior with total knee arthroplasty (TKA) by payer type. Five hundred and three primary TKAs were included. Preoperative radiographs were scored by Ahlback, Kellgren-Lawrence (KL), and International Knee Documentation Commi!ee (IKDC) classifications. Osteoarthritis severity by age and insurance type (private, Medicare, and Medicaid) were compared using Mann Whitney U and Kruskal-Wallis testing. Three hundred and two (60%) subjects were under 65 years old, and 201 (40%) were 65 years and older. Younger subjects had no differences in radiographic severity in KL (p = 0.268), Ahlback (p = 1), or IKDC (p = 0.948) classification by insurance. Older subjects also had no differences in osteoarthritis severity for KL (p = 0.282), Ahlback (p = 0.354), or IKDC (p = 0.735) classifications by insurance. Three osteoarthritis classification systems found no difference in preoperative radiographic changes by payor type, suggesting that, in the study’s population, there is no delay in appropriate surgical treatment by payer. Future studies should compare preoperative clinical symptoms. (Journal of Surgical Orthopaedic Advances 33(3):184-188, 2024)

Key words: payer type, osteoarthritis severity, total knee arthroplasty