Social and Demographic Health Disparities in Knee Osteoarthritis and Total Knee Arthroplasty

There has been increased awareness around the interplay between patients' social and demographic background and health outcomes. The influence of social determinants of health on patients outcomes has recently been recognized in orthopaedic literature. As knee osteoarthritis (OA) is one of the leading causes of disability in the world and the procedural volume of total knee arthroplasty (TKA) is rising with increased access and an aging population, better appreciation for these factors is imperative. This review seeks to examine the effect of sociodemographic factors on OA care and disease burden; and TKA outcomes. Our goal is to provide the arthroplasty surgeon community with a better understanding of how inequities in care and research impact our patients' OA and TKA outcomes. Previously published research has focused mainly on race and ethnicity, but the literature is limited, with what is available showing that there are disparate presentations and outcomes in both OA and TKA based on different social determinants of health. There is substantial work that will be required to better understand and address nonmodifiable risk factors and optimize surgery outcomes across all demographics.