Total knee replacement (TKR) is an effective, yet underutilized, treatment for severe knee osteoarthritis (OA). In particular, eligible minority patients tend to undergo TKR less often than white patients. The origins of these racial/ethnic disparities are incompletely understood, but may include both care-based (e.g. physician bias for recommending TKR) and patient-based (e.g. decisions not to undergo TKR if recommended) factors.