The effect of Area Deprivation Index on clinical outcomes after total shoulder arthroplasty.

Background: Socioeconomic status (SES), as measured by the Area Deprivation Index (ADI), is associated with differences in pre-operative status and post-operative outcomes in patients undergoing total shoulder arthroplasty (TSA). The effect of SES on TSA outcomes remains unclear, as studies thus far report mixed findings overall. The purpose of this study is to determine the association between SES at the neighborhood level, using ADI scores, and patient-reported outcome measures (PROMs) following TSA. Methods: A retrospective review of a prospectively collected single-institution database was performed to identify patients who underwent primary TSA (Advita Ortho) with a minimum 2-year follow-up. Patient addresses were collected and converted to ADI scores. Patients were divided into quartiles of ADI, and the most deprived (ADI Results: A total of 599 procedures with a minimum of 2-year follow-up and ADI score were grouped into distinct quartiles for analysis, and the ADI Conclusion: SES impacts pre-operative disease severity and absolute post-operative outcomes after TSA but does not significantly limit the capacity for clinically meaningful improvement. Disadvantaged patients derive similarly substantial benefit from surgery compared to those from higher SES backgrounds.