BACKGROUND The purpose of this study was to explore the impact of social deprivation on preoperative characteristics and postoperative outcomes following hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS). METHODS Patients undergoing primary HA for FAIS were identified, and their social deprivation index (SDI) score was assigned on the basis of the provided ZIP code. Quartiles (Q1 to Q4) were established using national percentiles, with Q4 representing patients from the areas of greatest deprivation. Patient-reported outcomes (PROs) were collected preoperatively and at a minimum follow-up of 2 years. Achievement rates for clinically meaningful outcomes, including the minimal clinically important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB), were determined. The incidences of revision HA and conversion to total hip arthroplasty (THA) were recorded. SDI groups were compared with respect to preoperative characteristics and postoperative outcome measures. Predictors of MCID, PASS, and SCB achievement; revision HA; and conversion to THA were identified with use of multivariable logistic regression. RESULTS In total, 2,060 hips were included, which had the following SDI distribution: Q1 = 955, Q2 = 580, Q3 = 281, and Q4 = 244. The composition of the included patients with respect to race and/or ethnicity was 85.3% Caucasian, 3.8% African American, 3.7% Hispanic, 1.7% Asian, and 5.4% "other." Patients with more social deprivation presented at a later age and with a higher body mass index (BMI), a longer duration of preoperative hip pain, and greater joint degeneration (p ≤ 0.035 for all). The most socially deprived groups had higher proportions of African American and Hispanic individuals, less participation in physical activity, and greater prevalences of smoking, lower back pain, and Workers' Compensation (p ≤ 0.018 for all). PRO scores and achievement of the PASS and SCB were worse among patients from areas of greater social deprivation (p ≤ 0.017 for all). Age, BMI, activity status, race and/or ethnicity classified as "other," SDI quartile, Workers' Compensation, preoperative back pain, duration of preoperative hip pain, and Tönnis grade were independent predictors of clinically meaningful outcome achievement, revision arthroscopy, and/or THA conversion (p ≤ 0.049 for all). CONCLUSIONS Individuals with more social deprivation demonstrated inferior postoperative outcome measures. This was driven primarily by preoperative characteristics such as SDI, hip pain duration, joint degeneration, and overall health at presentation. Despite differential outcomes, patients still showed clinical improvement regardless of SDI quartile. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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髋关节镜检查后的人口差异和结果：探索健康的社会决定因素对股骨髋臼撞击综合征的影响。


背景 本研究的目的是探讨社会剥夺对股骨髋臼撞击综合征 （FAIS） 髋关节镜检查 （HA） 术后特征和术后结局的影响。方法 确定接受 FAIS 原发性 HA 的患者，并根据提供的邮政编码分配他们的社会剥夺指数 （SDI） 评分。四分位数（第 1 季度至第 4 季度）是使用全国百分位数建立的，其中第 4 季度代表来自最贫困地区的患者。术前收集患者报告结果 （PROs），至少随访 2 年。确定了具有临床意义的结局的实现率，包括最小临床重要差异 （MCID） 、患者可接受的症状状态 （PASS） 和实质性临床获益 （SCB）。记录翻修 HA 和转为全髋关节置换术 （THA） 的发生率。比较 SDI 组的术前特征和术后结局指标。MCID、PASS 和 SCB 成就的预测因子;修订版 HA;和转换为 THA 是使用多变量 logistic 回归确定的。结果 总共包括 2,060 个髋关节，其 SDI 分布如下：Q1 = 955，Q2 = 580，Q3 = 281 和 Q4 = 244。纳入患者的种族和/或民族构成为 85.3% 白种人、3.8% 非裔美国人、3.7% 西班牙裔、1.7% 亚裔和 5.4% “其他”。社交剥夺较多的患者年龄较大，体重指数 （BMI） 较高，术前髋部疼痛持续时间较长，关节退化较严重 （全部 p ≤ 0.035）。 社会最贫困的群体非裔美国人和西班牙裔人的比例较高，参与体育活动的比例较高，吸烟、腰痛和工伤赔偿的患病率较高（p ≤ 0.018）。来自社会剥夺较严重地区的患者的 PRO 评分以及 PASS 和 SCB 的成绩较差 （p ≤ 0.017）。年龄、BMI、活动状况、归类为“其他”的种族和/或民族、SDI 四分位数、工伤赔偿、术前背痛、术前髋部疼痛持续时间和 Tönnis 分级是有临床意义的结果实现、翻修关节镜检查和/或 THA 转换的独立预测因子（全部 p ≤ 0.049）。结论 社会剥夺程度较高的个体术后结局指标较差。这主要由术前特征驱动，例如 SDI、髋关节疼痛持续时间、关节退化和就诊时的整体健康状况。尽管结果不同，但无论 SDI 四分位数如何，患者仍然表现出临床改善。证据级别 预后 III 级。有关证据级别的完整描述，请参阅作者说明。