Socioeconomic Status is Not Associated With Complications Following Revision Total Joint Arthroplasty

Socioeconomic disparities are known to affect outcomes after primary total hip and knee arthroplasty. Revision procedures may be similarly associated, though this relationship remains unclear. This study examined the association between socioeconomic status (SES), measured by the Distressed Communities Index (DCI), and short-term complication rates following revision total hip (rTHA) and knee arthroplasty (rTKA).This retrospective cohort study included 851 consecutive revision arthroplasties (502 rTKAs, 349 rTHAs) performed between January 1st, 2018, and January 1st, 2025, with at least 6 months of follow-up. Preoperative and postoperative data were collected via chart review. Multivariate regression analyses were conducted, adjusting for demographic and clinical variables. Alpha was set at 0.05. Higher Charleston Comorbidity Index (CCI) was associated with increased 90-day medical complications in both rTHA and rTKA (p < 0.001). Higher EBL was also associated with greater medical complications for rTHA patients (p = 0.048). Younger age, higher CCI, and greater operative time correlated with higher surgical complication rates in rTKA (p < 0.05). DCI was associated with increased postoperative opioid use in rTHA patients and decreased 30-day readmission in rTKA patients (p = 0.005 and 0.025, respectively). However, after adjusting for pain, DCI was not independently associated with 90-day complications. Post hoc analysis demonstrated adequate statistical power. SES, as measured by the DCI, was not independently associated with short-term postoperative complications following rTHA or rTKA.

These findings suggest that DCI and similar indices used in isolation may have limited utility in risk-stratifying revision arthroplasty patients.