February 2025 Journal Club: Linda Suleiman Racial Concordance in TKA

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January 2025

JRGOS Journal Club

Patient-Physician Racial Concordance increases Likelihood of Total Knee Arthroplasty Recommendation

Linda Suleiman,Rachel Bergman,Manasa Pagadala,T Jacob Selph Jr,

Patricia Franklin,Adam Edelstein

J Arthroplasty. 2024 Nov 17:S0883-5403(24)01210-5. doi:10.1016/j.arth.2024.11.019. PMID: 39551406.

Linda Suleiman, MD is the recipient of the 2025 JRGOS Presidents Health Equity & Diversity Award, presented to an individual that reflects the ethos and achievement of past, present, and future JRGOS Presidents. The recipient of this award emphasizes leadership in Orthopaedic Surgery, advancement of culturally sensitive care, a commitment to diversity and inclusivity, educational impact, clinical and academic excellence, innovation in Orthopaedic practices, service, and humanitarian contributions. The award will be presented on March 13, 2025 at the JRGOS Annual Luncheon. Dr. Suleiman is an Associate Professor in the Department of Orthopaedic Surgery and Medical Education at Northwestern University Feinberg School of Medicine and isthe Associate Dean of Medical Education and Director of Diversity and Inclusion for Graduate Medical Education.Dr. Suleiman has been a Gladden Member since 2009.Dr. Suleiman is the first Black woman to graduate from Northwestern University’s Orthopaedic Residency program. Dr. Suleiman will become the Vice President of the Ruth Jackson Orthopaedic Society (RJOS) in March 2025 and will start her presidential line in 2026.

This study, Patient-Physician Racial Concordance Increases Likelihood of Total Knee Arthroplasty Recommendation, examines racial concordance between patients and physicians and the likelihood of a surgical recommendation for total knee arthroplasty (TKA). The study included 314 patients and four physicians (one Black and three non-Hispanic White) from a single institution in Chicago, Illinois. After patients were assessed as appropriate candidates for surgery according to the American Academy of Orthopaedic Surgeons (AAOS) appropriate use criteria, the researchers reviewed clinic notes to determine whether each patient was recommended for surgery.

Table depicting the influence of racial concordance/discordance on TKA recommendation.

In their cohort, 45.8% of patients identified as non-Hispanic White (NHW), 36.6% as Black, 10.7% as Latino, and 6.9% as other. The study found that Black patients who received racially concordant care were more likely to be offered surgery compared to those who received racially discordant care (55.1% vs. 23.0%, P = 0.0001). Additionally, Black patients who received racially concordant care were significantly more likely to be recommended for total knee arthroplasty (TKA) than NHW patients who received racially concordant care (55.1% vs. 30.2%, P = 0.0002).

The study concluded that racial concordance between physician and patient increases the likelihood of a TKA recommendation. The authors suggest that “increasing representation among healthcare providers can help reduce implicit biases, enhance cultural competency, and foster more equitable care.”

Patient-Physician Racial Concordance increases Likelihood of Total Knee Arthroplasty Recommendation