Health-Related Social Needs Associated With Worse Patient-Reported Outcomes and Increased Adverse Events Following Total Joint Arthroplasty

Background Health-related social needs (HRSNs) are the individual-level adverse social conditions that negatively impact a person's health. This study characterizes the association of HRSNs with patient-reported outcomes and adverse events following total hip (THA) and knee arthroplasty (TKA). Methods This single-institution cross-sectional study utilized the Centers for Medicare & Medicaid Services HRSN Screening Tool. In-person interviews captured HRSNs, patient-reported outcome measures, and demographic data from postoperative THA and TKA patients in an academic arthroplasty practice. Charlson Comorbidity Index, American Society of Anesthesiologists scores, discharge data, and 90-day complications were collected via chart review. Regression analysis was used to determine associations between HRSNs and outcomes. Results Among 190 patients, food insecurity had a significant association with reoperation (odds ratio (OR) = 5.78, 95% confidence interval 1.44-23.2, P = .013). Patients with food and transportation HRSNs had significantly worse postoperative physical function, pain, and mobility (all P < .05). Black patients had significantly higher odds of visiting the emergency department (OR = 2.15, 95% CI 1.10-4.20, P = .025) or being readmitted (OR = 2.70, 95% confidence interval 1.11-6.58, P = .029) within 90 days postoperation compared to White patients. Conclusions Food insecurity was associated with increased odds of reoperation, and food insecurity and transportation were associated with worse patient-reported outcomes following THA and TKA. Black patients had increased risks of readmission and emergency department visits. These findings highlight the critical impacts of HRSNs on THA and TKA outcomes and underscore the need for targeted interventions addressing HRSNs to improve postoperative recovery and health-care equity.