Two Decades Since the Unequal Treatment Report: The State of Racial, Ethnic, and Socioeconomic Disparities in Elective Total Hip and Knee Replacement Use

J Bone Joint Surg Am. 2025 Mar 5;107(5):523-538. doi: 10.2106/JBJS.24.00347. Epub 2024 Nov 20.

Abstract

Published in 2003 by the Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care placed an unprecedented spotlight on disparities in the U.S. health-care system. In the 2 decades since the publication of that landmark report, disparities continue to be prevalent and remain an important significant national concern. This article synthesizes the evolution, current state, and future of racial and ethnic disparities in the use of elective total joint replacement surgeries. We contextualize our impressions with respect to the recommendations of the Unequal Treatment Report.

Publication types

  • Review

MeSH terms

  • Arthroplasty, Replacement, Hip* / statistics & numerical data
  • Arthroplasty, Replacement, Hip* / trends
  • Arthroplasty, Replacement, Knee* / statistics & numerical data
  • Arthroplasty, Replacement, Knee* / trends
  • Elective Surgical Procedures* / statistics & numerical data
  • Ethnicity / statistics & numerical data
  • Healthcare Disparities* / ethnology
  • Healthcare Disparities* / statistics & numerical data
  • Healthcare Disparities* / trends
  • Humans
  • Racial Groups
  • Socioeconomic Disparities in Health
  • Socioeconomic Factors
  • United States