Examining Disparities in Regional Anesthesia Utilization, Opioid Prescriptions, and Pain Scores Among Patients Who Received Primary or Revision Total Knee Arthroplasty at a Veterans Affairs Medical Center: A Retrospective Cohort Study.

This article focuses on sociodemographic disparities in perioperative pain management among veterans undergoing total knee arthroplasty (TKA) at the Atlanta Veterans Affairs Health Care System (AVAHCS). The retrospective study analyzed data from 562 veterans who had primary or revision TKA between 2014 and 2020, examining factors such as race, age, surgery type, use of regional anesthesia (RA), and opioid prescribing measured in oral morphine equivalents (OME). Findings indicated that Black patients were more likely to undergo revision TKA and reported higher baseline and 24-hour postoperative pain scores but were prescribed significantly fewer opioids at discharge compared to White patients. Older patients (>65 years) also received fewer opioids despite similar pain scores, while none of the variables studied—including race, age, surgery type, or pain scores—were significantly associated with the use of RA, suggesting equitable distribution of RA in this cohort. The study highlights persistent disparities in opioid prescribing despite equal access to care within the VA system and calls for further research and targeted interventions to address these inequities.