Work

Socioeconomic Disparities in Outcomes After Primary Total Hip Arthroplasty: A Propensity-Matched Multi-Institutional Study

Year: 2026

Type: article

Abstract: Background: Socioeconomic disadvantage has been associated with poorer outcomes following total hip arthroplasty (THA). This study evaluated the relationship between social determinants of health (SDoH) and short- and long-term postoperative outcomes after primary THA. Methods: A retrospective cohort study was conducted using the TriNetX Dataworks-USA network. Adult patients undergoing elective primary THA were identified and stratified based on the presence of at least 1 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) SDoH Z-code (Z55-Z65). Cohorts were matched in a 1:1 ratio using greedy nearest-neighbor propensity score matching with a caliper of 0.1 standard deviations of the logit of the propensity score, adjusting for age, sex, and medical comorbidities. Standardized mean differences <0.1 were considered indicative of adequate covariate balance. Postoperative outcomes evaluated included superficial surgical site infection, deep vein thrombosis, sepsis, myocardial infarction, and all-cause mortality at 30 days, 90 days, and 1 year following surgery. Risk ratios with 95% confidence intervals were calculated. Results: After matching, 15,922 patients remained in each cohort. Patients with SDoH risk factors demonstrated significantly increased risks of superficial surgical site infection, deep vein thrombosis, sepsis, myocardial infarction, and all-cause mortality at multiple postoperative time points compared with controls. Elevated mortality risk persisted through 1 year postoperatively. Conclusions: Socioeconomic disadvantage, as identified by SDoH Z-codes, was associated with worse short- and long-term outcomes following primary THA. These findings support the incorporation of social risk factors into perioperative risk stratification and optimization strategies.

Source: Arthroplasty Today

DOI: 10.1016/j.artd.2026.102131

Authors: Kevin Artus, Lakshaye Anand, Zenya Yanoff, Seth Shoap

Institution: Pennsylvania State University

Language: English

Topic: Total Knee Arthroplasty Outcomes

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $2,500