Regional anesthesia was near-universal (98.8%) for total joint arthroplasty at a specialized orthopedic hospital
Source
Jj (2025). Association Between Limited English Proficiency and Regional Anesthesia Utilization for Total Joint Arthroplasty: A Retrospective Single-Institution Study.. Anesthesia and analgesia.
Description #
At the Hospital for Special Surgery, a high-volume specialized orthopedic center, regional anesthesia was essentially the default for total joint arthroplasty: of 58,918 THR/TKR patients from 2016 to 2023, 58,211 (98.8%) received their procedure under RA, leaving only 707 (1.2%) without (Table). This near-ceiling utilization is the backdrop against which the authors interpret their null language finding, since RA is the institutional standard of care.
"We identified 58,918 patients undergoing a total joint arthroplasty from 2016 to 2023 with 58,211 (98.8%) underwent their procedure with RA (Table)." (Sabra, 2025, p. 995)
"RA is considered the standard of care at most orthopedic centers for patients undergoing total joint arthroplasty and is recommended by the International Consensus on Anesthesia Related Outcomes after Surgery group (ICAROS)." (Sabra, 2025, pp. 995–996)
Methods Context #
What? #ⓘ
The observable: the proportion of total joint arthroplasty patients receiving regional (neuraxial/peripheral nerve block) anesthesia versus general anesthesia.
"The primary outcome is RA (neuraxial/peripheral nerve block) utilization for English versus LEP patients." (Sabra, 2025, p. 993)
How? #ⓘ
Descriptive count/percentage from an Epic EMR search of all primary elective unilateral THR/TKR cases over an 8-year window (2016–2023), STROBE-adherent retrospective design.
"An Epic electronic medical record (EMR) search was conducted for all patients undergoing THR or TKR between January 1, 2016, and December 31, 2023." (Sabra, 2025, p. 993)
Who? #ⓘ
58,918 patients aged >18 undergoing primary, elective, unilateral THR/TKR at the Hospital for Special Surgery (HSS), New York — a specialized high-volume orthopedic hospital.
"This retrospective study was approved by the Institutional Review Board (IRB# 2024-0071) at the Hospital for Special Surgery (HSS)." (Sabra, 2025, p. 993)
Other Notes #
The near-universal RA rate (and the correspondingly tiny non-RA group of 707, of whom only 13 were LEP) means there is little outcome variance in which a language-based disparity could manifest — a ceiling effect the authors partly attribute to their institutional A-0006ArtifactA-0006Initial AI draftHSS perioperative Language Service programA hospital-wide language-services program at the Hospital for Special Surgery (HSS) that provides translation and language-concordant materials to LEP patients across the perioperative pathway. The authors hypothesize it…. See qualifying caveats.