Sociodemographic Differences in Long-Term Function After Total Hip and Knee Arthroplasty: A Scoping Review

Area of Science:

• Orthopedic surgery
• Health services research
• Health equity

Background:

• Long-term functional outcomes after total hip arthroplasty (THA) and total knee arthroplasty (TKA) are crucial for patient recovery.
• Sociodemographic disparities may influence these outcomes, but comprehensive reviews are limited.

Purpose of the Study:

• To conduct a scoping review summarizing evidence on sociodemographic disparities in long-term functional outcomes following THA and TKA.
• To identify gaps in the literature regarding these disparities.

Main Methods:

• A systematic search of five databases was performed by a librarian.
• Inclusion criteria focused on US-based original research examining long-term functional outcomes (≥6 months postoperative) by sex, race, ethnicity, socioeconomic status, and/or geography.
• Seventy-nine articles met the inclusion criteria.

Main Results:

• Men reported better long-term functional outcomes than women in 60% of post-THA and 51% of post-TKA studies.
• White patients showed better long-term function compared to minoritized patients in 63% of post-THA and 69% of post-TKA outcomes.
• Higher socioeconomic status was associated with better long-term function in 63% of post-THA and 71% of post-TKA outcomes.
• Limited data existed on geographic disparities, with no significant disparities found.

Conclusions:

• Evidence suggests disparities in long-term functional outcomes post-THA/TKA exist across racial, ethnic, and socioeconomic groups.
• Significant data gaps remain for smaller minority populations, rural communities, and intersecting sociodemographic variables.
• Further research is needed to identify at-risk patients and develop targeted protocols for enhanced functional recovery.