Effect of Marital Status on Outcomes Following Total Joint Arthroplasty

• Published in: Archives of orthopaedic and trauma surgery Vol. 142; no. 12; pp. 3651 - 3658
• Main Authors: Singh, Vivek, Fiedler, Benjamin, Kugelman, David N., Meftah, Morteza, Aggarwal, Vinay K., Schwarzkopf, Ran
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2022; Springer Nature B.V
• Subjects: Arthritis; Body mass index; Bone surgery; Clinical outcomes; Emergency medical care; Hospitals; Independent sample; Joint surgery; Knee; Length of stay; Marital status; Medicine; Medicine & Public Health; Orthopaedic Surgery; Orthopedics; Osteoarthritis; Patients; Questionnaires; Social support; Socioeconomic factors; Surgical outcomes; Trauma; Patient reported outcome measures; Total knee arthroplasty; Marital status; Total joint arthroplasty; Total hip arthroplasty; Outcomes
• DOI: 10.1007/s00402-021-03914-z
• ISSN: 1434-3916; 0936-8051

Introduction The purpose of this study is to investigate whether the specific socioeconomic factor such as marital status has any effect on clinical outcomes and patient-reported outcome measures (PROMs) after primary total hip (THA) and knee (TKA) arthroplasty. Materials and methods We retrospectively reviewed patients who underwent primary THA or TKA from January 2019 to August 2019 who answered all PROM questionnaires. Both THA and TKA patients were separated into two groups based on their marital status at the time of surgery (married vs. non-married). Demographics, clinical data, and PROMs (FJS-12, HOOS, JR, KOOS, JR, and VR-12 PCS&MCS) were collected at various time-periods. Demographic differences were assessed using chi-square and independent sample t tests. Clinical data and mean PROMs were compared using multilinear regressions while accounting for demographic differences. Results This study included 389 patients who underwent primary THA and 193 that underwent primary TKA. In the THA cohort, 256 (66%) patients were married and 133 (34%) were non-married. In the TKA cohort, there were 117 (61%) married patients and 76 (39%) non-married patients. Length of stay was significantly shorter for married patients in both the THA (1.30 vs. 1.64; p  = 0.002) and TKA (1.89 vs. 2.36; p  = 0.024) cohorts. Surgical-time, all-cause emergency department visits, discharge disposition, and 90-day all-cause adverse events (readmissions/revisions) did not statistically differ between both cohorts. Both HOOS, JR and KOOS, JR score improvements from baseline to 1-year did not statistically differ for the THA and TKA cohorts, respectively. Although VR-12 PCS ( p  = 0.012) and MCS ( p  = 0.004) score improvement from baseline to 1-year statistically differed for the THA cohort, they did not for the TKA cohort. Conclusion Total joint arthroplasty may yield similar clinical benefits in all patients irrespective of their marital status. Although some PROMs statistically differed among married and non-married patients, the differences are likely not clinically significant. Surgeons should continue to assess levels of psychosocial support in their patients prior to undergoing TJA to optimize outcomes. Level of evidence III, Retrospective Cohort Study.