Surgeons can use educationally based decision aids to improve rates of knee arthroplasty utilization among African Americans, according to the authors of a recent study.1

The decision aids should include information about pre- and postoperative pain and performance outcomes, showing that these outcomes are not likely to be different for African Americans vs. non-African Americans.

“It would be an algorithm, a flow chart, where the patient provides various types of information about what their problems are, how much pain they have, and other aspects of life affected by knee issues,” says Daniel L. Riddle, PT, PhD, FAPTA, professor in the departments of physical therapy, orthopedic surgery, and rheumatology, Virginia Commonwealth University in Richmond.

The decision aid could include social determinants of health, as well as the typical questions about the usual conditions, such as:

  • comorbidities;
  • psychological distress;
  • joints affected by arthritis;
  • patient’s activities of daily living affected by pain;
  • patient’s independence level;
  • patient’s functional deficits.

“It’s still in the formative stages of development for researchers, who are chasing the best ways of getting these decision aids,” Riddle says. “This is something we’ll see in the next few years.”


  1. Riddle DL, Slover J, Keefe FJ, et al. Racial differences in pain and function following knee arthroplasty: A secondary analysis from a multicenter randomized clinical trial. Arthritis Care Res (Hoboken) 2020; Mar 7:10.1002/acr.24177. doi: 10.1002/acr.24177. [Online ahead of print].