Introduction: Socioeconomic status (SES) has been associated with differences in patient-reported outcome scores and complication rates across orthopedics. Area Deprivation Index (ADI) is a validated measure of an area’s socioeconomic status based on 17 different census variables. ADI has been associated with complications following total knee arthroplasty and may be associated with clinical outcomes and complications following rotator cuff repair.  The purpose of this study is to investigate the impact socioeconomic factors have on outcomes following primary arthroscopic rotator cuff repair.   
  
Methods: Patients who underwent primary rotator cuff repair at a single institution from 3/11/2014-9/29/2022 were identified. Patient demographics, pre- and post-operative Visual Analog Scale (VAS) scores, Patient-Reported Outcomes Measurement Information System (PROMIS) scores—specifically PROMIS Upper Extremity (UE) function, PROMIS Pain Interference (PI), and PROMIS Depression (D)—range of motion, complications, and subsequent ipsilateral shoulder surgeries were collected. ADI was collected from an online mapping database using each patient’s home address. Patients were split into ADI terciles, with ADI 1 representing the least disadvantaged group and ADI 3 representing the most disadvantaged group. ANOVA, T-test and chi-square analyses were conducted for continuous variables and categorical variables, respectively.   
  
Results: In total 467 patients underwent rotator cuff repair and had complete demographic data and postoperative follow-up through one year. There was a significant difference in race, with 78.2% of patients identifying as black in ADI 3 versus 18.1% in ADI 1 (P<0.001). Pre-operative PROMIS-PI, VAS, forward flexion (FF), and abduction (ABD) were significantly worse in ADI 3 compared to ADI 1 (P=0.001, P<0.001, P=0.012, P=0.023). Patients in ADI 3 had significantly worse PROMIS-UE score, PROMIS-PI, VAS, FF and ABD at 1-year postoperatively compared to ADI 1 (P=0.016, P<0.001, P<0.001, P<0.001, P=0.034). 9.8% of patients in ADI 1, 32.6% in ADI 2 and 57.6% in ADI 3 experienced a postoperative complication (P=0.54). Retears were more common in ADI 3 (62%) compared to ADI 2 (28%) and ADI 1 (10%) (P=0.47). There was a greater but not significant number of reoperations performed for patients in ADI 3 (63.4%) compared to ADI 2 (31.7%) and ADI 1 (4.9%) (P=0.22).   
  
Conclusion: Lower socioeconomic status measured by ADI is associated with worse preoperative and 1-year postoperative pain, shoulder function and range of motion following rotator cuff repair, but no difference in reoperation or complications.

Lower Socioeconomic Status is Correlated with Worse Outcomes After Arthroscopic Rotator Cuff Repair

Orthopaedic Surgery (Public Health and Health Policy)

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Mahdi Mazeh

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Lower Socioeconomic Status is Correlated with Worse Outcomes After Arthroscopic Rotator Cuff Repair

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