Comorbidity profiles associated with total knee arthroplasty in a medically underserved population

Total knee arthroplasty (TKA) is a common orthopedic procedure that is increasing in incidence and prevalence and is rising in younger populations. The Rio Grande Valley (RGV) represents a medically underserved region in the southern United States characterized by high rates of chronic conditions such as obesity, diabetes, and arthritis. The purpose of this study is to investigate the relationship between pre-existing chronic medical conditions and TKA within this medically underserved and at-risk population. This retrospective chart review was conducted using data obtained from University of Texas Rio Grande Valley medical records spanning January 1, 2018, through January 1, 2025. Medical charts of patients diagnosed with selected pre-existing medical conditions were reviewed using ICD-10 codes. In addition, charts of patients who underwent TKA were identified using CPT codes. Bivariate and multivariate analyses were performed, and results were reported as odds ratios (OR) with 95% confidence intervals (CI). Multivariate analysis showed that being obese/overweight (OR = exp (0.9) ≈ 2.46, p = 0.001) and individuals with vascular disease (OR = exp (0.848) ≈ 2.34, p < 0.001) had significantly higher odds of TKA. Individuals who were overweight/obese had 2.5 times increased odds of TKA compared to individuals without TKA. Individuals with vascular disease had 2.3 times increased odds of TKA compared to individuals without vascular disease. Individuals with T2DM (OR = exp (-0.41) ≈ 0.66, p = 0.034), tobacco use (OR = exp (-1.47) ≈ 0.23, p = 0.012), alcohol misuse (OR = exp (-1.07) ≈ 0.34, p = 0.02), and anemia (OR = exp (-1.32) ≈ 0.27, p < 0.001) had decreased odds of TKA. These results underscore the need for comprehensive risk assessment and targeted prevention strategies in populations at risk for advanced knee osteoarthritis, such as the chronic disease stricken and medically underserved regions.