1. Relationship Between Neighborhood-Level Socioeconomic Status and Functional Outcomes After Hip Arthroscopy.
- Author
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Lee, Jonathan S., Rachala, Rohit R., Gillinov, Stephen M., Siddiq, Bilal S., Dowley, Kieran S., Cherian, Nathan J., and Martin, Scott D.
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HIP surgery , *HIP joint injuries , *PEARSON correlation (Statistics) , *T-test (Statistics) , *RESEARCH funding , *FUNCTIONAL assessment , *ARTHROSCOPY , *VISUAL analog scale , *QUESTIONNAIRES , *REHABILITATION , *FISHER exact test , *LOGISTIC regression analysis , *SEX distribution , *DESCRIPTIVE statistics , *RETROSPECTIVE studies , *TREATMENT effectiveness , *PREOPERATIVE care , *FEMORACETABULAR impingement , *CHI-squared test , *MULTIVARIATE analysis , *AGE distribution , *LONGITUDINAL method , *REOPERATION , *HEALTH outcome assessment , *PATIENT satisfaction , *DATA analysis software , *SOCIAL classes , *NEIGHBORHOOD characteristics , *PATIENT aftercare - Abstract
Background: Despite the growing volume of neighborhood-level health disparity research, there remains a paucity of prospective studies investigating the relationship between Area Deprivation Index (ADI) and functional outcomes for patients undergoing hip arthroscopy. Purpose: To investigate the relationship between neighborhood-level socioeconomic status and functional outcomes after hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis of prospectively collected data was performed on patients aged ≥18 years with minimum 1-year follow-up who underwent hip arthroscopy for the treatment of symptomatic labral tears. The study population was divided into ADILow and ADIHigh cohorts according to ADI score: a validated measurement of neighborhood-level socioeconomic status standardized to yield a score between 1 and 100. Patient-reported outcome measures (PROMs) included the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports-Specific Subscale, 33-item International Hip Outcome Tool, visual analog scale for pain, and patient satisfaction. Results: A total of 228 patients met inclusion criteria and were included in the final analysis. After patients were stratified by ADI score (mean ± SD), the ADILow cohort (n = 113; 5.8 ± 3.0; range, 1-12) and ADIHigh cohort (n = 115; 28.0 ± 14.5; range, 13-97) had no differences in baseline patient demographics. The ADIHigh cohort had significantly worse preoperative baseline scores for all 5 PROMs; however, these differences were not present by 1-year follow-up. Furthermore, the 2 cohorts achieved similar rates of the minimal clinically important difference for all 5 PROMs and the Patient Acceptable Symptom State for 4 PROMs. When controlling for patient demographics, patients with higher ADI scores had greater odds of achieving the minimal clinically important difference for all PROMs except the 33-item International Hip Outcome Tool. Conclusion: Although hip arthroscopy patients experiencing a greater neighborhood-level socioeconomic disadvantage exhibited significantly lower preoperative baseline PROM scores, this disparity resolved at 1-year follow-up. In fact, when adjusting for patient characteristics including ADI score, more disadvantaged patients achieved greater odds of achieving the minimal clinically important difference. The present study is merely a first step toward understanding health inequities among patients seeking orthopaedic care. Further development of clinical guidelines and health policy research is necessary to advance care for patients from disadvantaged communities. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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