disparities; hip replacement; outcomes; function


Orthopedics | Physiotherapy | Surgery



Disparities in total joint arthroplasty are well-documented. However, much of the research regarding disparities in vulnerable populations receiving total hip arthroplasty (THA) have focused on short-term outcomes. The purpose of this study was to examine the effects of race, gender, and socioeconomic status (SES) on patient-reported outcomes six months following THA.


Electronic health record data were retrospectively analyzed for 269 individuals who underwent THA at a large urban hospital from 2013-16. Data retrieved included patient demographics, baseline health information, data regarding hospital length of stay when undergoing THA, post-operative complications, and patient-reported function, measured by the Harris Hip Score (HHS) at baseline (pre-operative) and six months post-operatively.


Compared to White patients and male patients, non-White (p = .01) and female (p = .02) patients were lower-functioning prior to surgery. At six months post-operatively, White patients had significantly better function than non-White patients, (p = .05) and patients of higher SES had significantly better function than patients of lower SES (p = .05). Regression analyses revealed that, after controlling for race, gender, and SES, the only significant predictor of six-month improvement in HHS was the pre-operative HHS score (p < .001).


These results indicate that female, non-White, and lower SES patients undergoing THA may have lower function pre-operatively and may not experience as much improvement in physical function post-operatively as their male, White, and higher SES counterparts.

Further research is needed to determine if race, gender, and socioeconomic differences in pre-operative function lead to long-term disparities in function following THA, using larger sample sizes and outcomes beyond 6 months post-operatively.