DEPRIVATION, COMPLEXITY, AND MORTALITY IN KNEE ARTHROPLASTY

Abstract

AbstractIntroductionKnee replacement surgery can greatly improve pain, disability, quality of life and ability to work. Socioeconomic deprivation is associated with multiple poor health outcomes, partly due to reduced access to services, including surgery. We investigated whether deprivation was associated with characteristics at presentation, and outcomes following knee arthroplasty.MethodologyWe linked data from 2358 knee arthroplasty cases with the Index of Multiple Deprivation, and mortality data after mean 7.6 years follow up. A locally developed scoring system was used prospectively to categorise case complexity.ResultsMost patients were from more affluent areas. Deprivation was associated with younger age, and increasing case complexity. There was a significant association between case complexity and mortality, while an independent association between deprivation and mortality could not be confirmed.ConclusionHealth inequalities may impact presentations and outcomes in knee arthroplasty. Patients from areas of socioeconomic deprivation present more complex cases, which may be a result of associated comorbidity and delayed presentation due to impaired access. As knee arthroplasty can improve disability and ability to work, its availability in deprived areas can play a role in the alleviation of health inequality.