Socioeconomic Deprivation and Healthcare Burden After Elective Lower-Limb Arthroplasty: A Retrospective Cohort Study of 1,976 Patients

Socioeconomic deprivation is widely associated with poorer healthcare outcomes and increased healthcare burden. However, deprivation’s influence on outcomes after elective total joint arthroplasty (TJA) remains unclear. This study examined whether deprivation, measured by Scottish Index of Multiple Deprivation (SIMD 2020), was associated with increased healthcare burden or 1-year complication rate after TJA. A single-centre retrospective cohort study was conducted over a 2-year period. Postcodes were analysed into SIMD 2020 quintiles (1 = most deprived and 5 = least deprived). Baseline co-variables included Clinical Frailty Scale (CFS), ASA, Charlson co-morbidity index (CCI), Age, Sex, operation type and BMI. Outcomes included 1-year mortality, infection and repeat operation, as well as length of stay, time to mobilisation, GP onward referral, and days until clinic discharge. Univariate descriptive analyses were performed, with multivariate modelling employing linear regression (with log-transformed outcomes for skewed continuous outcomes) and logistic regression for binary outcomes. No statistically or clinically meaningful differences were observed across the deprivation quintiles for any primary or secondary outcome. Socioeconomic deprivation did not influence patient outcomes, in terms of healthcare utilisation or medium-term major complication rate following elective lower-limb arthroplasty within a standardised NTC pathway. These findings support equitable outcomes across deprivation levels.