Patient Social Determinants of Health Are Associated With Hip Dysfunction and Osteoarthritis Outcome Scores and Outcomes After Total Hip Arthroplasty.

Background: Disparities in access and outcomes persist for total hip arthroplasty (THA). The Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) is a validated patient-reported outcomes and measure and a proxy for quality of care. We examined whether patient social determinants of health were associated with HOOS scores and outcomes. Methods: We retrospectively identified 2938 THAs at a single institution from 2015 to 2023. Multivariate analyses were performed to determine if associations existed between patient factors (race, sex, marital status, age, insurance carrier, among others) and HOOS scores (preoperative, 6-week, and 1-year postoperative) or outcomes (length of stay [LOS], discharge disposition, or perioperative complications). Results: Lower preoperative HOOS scores were associated with being younger, unmarried, Black, higher body mass index, higher Elixhauser score, government insurance, posterior approach, and female ( Conclusions: Several social determinants of health were associated with LOS and discharge disposition. While Black patients had lower HOOS scores at all time points, score improvement did not differ by race. Further research is warranted into why certain demographics present with lower HOOS scores preoperatively, and whether these patients delay evaluation or are indicated for surgery later, among other potential reasons.