Patients in distressed communities may have lower return to sport rates after TJA
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Key takeaways:
- Patients from distressed communities had significantly lower return to sport rates after total joint arthroplasty.
- No significant differences were seen in other results between socioeconomic well-being groups.
SAN FRANCISCO — Although patients had similar functional benefits after total joint arthroplasty regardless of socioeconomic well-being, results presented here showed patients in more distressed communities had lower return to sport rates.
Nicholas F. Cozzarelli, BS, and colleagues surveyed 2,335 patients who underwent total joint arthroplasty from 2015 to 2020 on their sports and physical activity profile 5 years and 1 year preoperatively and 1 year and 4 years postoperatively. Researchers categorized patients into groups based on whether they had a socioeconomic well-being status of prosperous, comfortable or at risk and distressed based on the Distressed Communities Index (DCI), and correlated data with demographic and outcome scores.
“At every time point in our study, the patients from the more distressed communities were participating in physical activities at statistically significant lower rates. And at all different activities, there were lower reports in the more distressed groups, as well,” Cozzarelli said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
However, Cozzarelli said patients in distressed communities had no significant differences in various outcome scores compared with patients in the prosperous and comfortable status groups. Logistic regression models showed being in a more distressed community predicted whether a patient would participate in or return to sport.
“We did explore the reasons why some of these patients are not participating and we saw that patients from more prosperous communities were reporting higher reports of counseling from their surgeons, whereas the more distressed communities were not, which could be a reflection of insufficient counseling and higher needs of patients from areas with potentially lower health literacy,” Cozzarelli said. “But the DCI is a score that is composed of multiple different factors, and surgeons should be aware of it, its use and its implications in the future when counseling their patients.”
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Cozzarelli NF, et al. Paper 191. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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