title: Outcomes of total knee arthroplasty in English- versus non-English-speaking patients.
abstract: OBJECTIVE
  To compare outcomes of total knee arthroplasty (TKA) in English- versus non-English-speaking patients.
  
  
  METHODS
  193 women and 85 men (mean age, 72 years) underwent 117 left and 161 right primary TKAs. 237 and 41 patients were English and non-English speaking, respectively. Interpretation was provided. Pre- and post-operative functional outcomes were measured using the International Knee Society (IKS) score.
  
  
  RESULTS
  Most non-English-speaking patients were female (38 vs 3 of 41, p<0.001). The mean body mass index of non-English-speaking patients was significantly higher (34 vs 31 kg/m[2], p=0.003). 14 foreign languages were spoken among the 41 non-English-speaking patients, of which Greek and Italian were the most common. Non-English-speaking patients had significantly worse IKS scores both preoperatively and at the 12-month follow-up. The proportions of poor postoperative IKS scores were significantly higher in non-English-speaking patients (58% vs 27%, p<0.001), in whom pain was also significantly worse (p=0.017). In a multiple logistic regression analysis, being non-English speaking was the only predictor of poor functional outcome at the 12-month follow-up (odds ratio=2.77, confidence interval=1.25-6.14, p=0.012).
  
  
  CONCLUSIONS
  The non-English-speaking background of a patient is a predictor of less favourable functional outcome after TKA.
authors.affiliation: Department of Orthopaedics, University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Dowsey
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Broadhead
authors.forename: James D
authors.initials: JD
authors.lastname: Stoney
authors.forename: Peter F
authors.initials: PF
authors.lastname: Choong
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003144:Communication Barriers; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D010147:Pain Measurement; D020127:Recovery of Function; D012044:Regression Analysis; D016896:Treatment Outcome