title: Utilisation of primary total knee joint replacements across socioeconomic status in the Barwon Statistical Division, Australia, 2006-2007: a cross-sectional study.
abstract: OBJECTIVE
  There are few Australian data that examine the association between total knee joint replacement (TKR) utilisation and socioeconomic status (SES). This study examined TKR surgeries with a diagnosis of osteoarthritis (OA) performed for residents of Barwon Statistical Division (BSD) for 2006-2007.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  BSD, South-eastern Victoria, Australia
  
  
  METHODS
  All patients who underwent a TKR for OA, 2006-2007, and whose residential postcode was identified as within the BSD of Australia, and for whom SES data were available, were eligible for inclusion.
  
  
  METHODS
  Primary TKR data ascertained from the Australian Orthopaedic Association National Joint Replacement Registry. Residential addresses were matched with the Australian Bureau of Statistics census data, and the Index of Relative Socioeconomic Disadvantage was used to determine SES, categorised into quintiles whereby quintile 1 indicated the most disadvantaged and quintile 5 the least disadvantaged. Age-specific and sex-specific rates of TKR utilisation per 1000 person-years were reported for 10-year age bands.
  
  
  RESULTS
  Females accounted for 62.7% of the 691 primary TKR surgeries performed during 2006-2007. The greatest utilisation rates of TKR in males was 7.6 observed in those aged >79 years, and in 10.2 in females observed in those aged 70-79 years. An increase in TKR was observed for males in SES quintile four compared to quintile 1 in which the lowest utilisation which was observed (p=0.04). No differences were observed in females across SES quintiles.
  
  
  CONCLUSIONS
  Further investigation is warranted on a larger scale to examine the role that SES may play in TKR utilisation, and to determine whether any social disparities in TKR utilisation reflect health system biases or geographic differences.
authors.affiliation: NorthWest Academic Centre, Department of Medicine, The University of Melbourne, St Albans, Victoria, Australia.
authors.forename: Sharon Lee
authors.initials: SL
authors.lastname: Brennan
authors.forename: Tyman
authors.initials: T
authors.lastname: Stanford
authors.forename: Anita E
authors.initials: AE
authors.lastname: Wluka
authors.forename: Richard S
authors.initials: RS
authors.lastname: Page
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Graves
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kotowicz
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Nicholson
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco