Impact of social deprivation and ethnicity on patient-reported outcome measures in primary and revision hip and knee arthroplasty.

Aims: There is a paucity in the literature on the impact of social deprivation and ethnicity on patient-reported outcome measures (PROMs) in hip and knee arthroplasty. This study aimed to assess the impact of social deprivation and ethnicity on PROMs after hip and knee arthroplasty in a healthcare system which is free at the point of care. Methods: We reviewed collected data on patient demographic details, comorbidities, and PROMs (EuroQol five-dimension questionnaire, Oxford Hip Score, and Oxford Knee Score), in patients who underwent hip and knee arthroplasty procedures, both primary and revision. The primary outcome was impact of social deprivation on PROMs. Secondary outcomes included the impact of ethnicity, religion, and comorbidities on PROMs. Results: We identified 10,646 hip arthroplasties and 8,138 knee arthroplasties from the database. Of these, 6,093 patients who underwent hip arthroplasty and 4,681 patients who underwent knee arthroplasty were included. Patients from the most deprived areas, ethnic minorities, and in those for whom English is not their first language had lower preoperative PROMs. Higher levels of social deprivation were associated with higher levels of comorbidity. The trends are similar in revision hip and knee arthroplasty, but the net improvement in the PROMs was significantly lower in patients who underwent revision procedures when compared with a primary procedure. Conclusion: This study highlights that healthcare inequality exists in the UK among those undergoing hip and knee arthroplasty procedures. This is despite the substantial benefit these procedures can provide, irrespective of social deprivation, ethnicity, or first language.