{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T10:29:24Z","timestamp":1773570564538,"version":"3.50.1"},"reference-count":54,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Purpose<\/jats:title>\n To investigate the effects of neighborhood\u2010level socioeconomic disadvantage on health care accessibility and midterm functional outcomes for patients undergoing primary hip arthroscopy for the treatment of acetabular labral tears.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective analysis queried patients \u226518 years old who underwent primary hip arthroscopy for treatment of symptomatic labral tears secondary to femoroacetabular impingement syndrome, had complete patient\u2010reported outcome measures (PROMs) at minimum 8\u2010year follow\u2010up, and resided in the United States. All patients underwent surgery between May 2001 and September 2013. Using the area deprivation index (ADI) to quantify neighborhood\u2010level socioeconomic disadvantage, patients were divided into quartiles. Those in the least and most disadvantaged quartiles represented the ADI\n Low<\/jats:sub>\n and ADI\n High<\/jats:sub>\n cohorts, respectively. Health care accessibility and socioeconomic disadvantage were compared between cohorts using rural, Health Professional Shortage Area, medically underserved area\/population, insurance status, education level, and household income classifications. Collected PROMs included the modified Harris Hip Score (mHHS), Hip Outcome Score (HOS)\u2013Activities of Daily Living (HOS\u2010ADL), HOS\u2013Sports Specific Subscale (HOS\u2010SSS), Nonarthritic Hip Score, 33\u2010item International Hip Outcome Tool, and rates of conversion to total hip arthroplasty (THA).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The ADI\n Low<\/jats:sub>\n (ADI: 4.0 \u00b1 2.1) and ADI\n High<\/jats:sub>\n (ADI: 37.7 \u00b1 12.1) cohorts each consisted of 43 patients. A greater proportion of patients in ADI\n High<\/jats:sub>\n resided in rural communities (\n P<\/jats:italic>\n = .026), primary care Health Professional Shortage Areas (\n P<\/jats:italic>\n = .024), and medically underserved area\/populations (\n P<\/jats:italic>\n = .019). At a patient level, the ADI\n High<\/jats:sub>\n cohort had lower levels of insurance coverage (\n P<\/jats:italic>\n = .035), education (\n P<\/jats:italic>\n = .002), and household income (\n P<\/jats:italic>\n = .002). Finally, ADI\n High<\/jats:sub>\n patients achieved worse functional outcome scores for mHHS (\n P<\/jats:italic>\n = .008), Nonarthritic Hip Score (\n P<\/jats:italic>\n = .043), HOS\u2010ADL (\n P<\/jats:italic>\n = .020), and 33\u2010item International Hip Outcome Tool (\n P<\/jats:italic>\n = .041). By multivariate logistic regression, patients in ADI\n High<\/jats:sub>\n were nearly 11.4 and 10.4 times less likely to achieve the 10\u2010year patient acceptable symptom state for mHHS (odds ratio, 0.09;\n P<\/jats:italic>\n = .008) and HOS\u2010ADL (odds ratio, 0.10;\n P<\/jats:italic>\n = .018), respectively. Despite having significantly worse PROMs, patients in ADI\n High<\/jats:sub>\n underwent statistically similar rates of revision hip arthroscopy (ADI\n High<\/jats:sub>\n : 7.0% vs. ADI\n Low<\/jats:sub>\n : 4.7%;\n P<\/jats:italic>\n = .645) and conversion to THA (ADI\n High<\/jats:sub>\n : 11.6% vs ADI\n Low<\/jats:sub>\n : 20.9%;\n P<\/jats:italic>\n = .213).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Patients undergoing hip arthroscopy for acetabular labral treatment from neighborhoods with greater ADI scores experience worse health care accessibility, inferior mid\u2010term functional outcomes, and similar rates of conversion to THA.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n Level III, retrospective cohort.<\/jats:p>\n <\/jats:sec>","DOI":"10.1016\/j.arthro.2025.04.011","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T16:11:35Z","timestamp":1744733495000},"page":"3985","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patients Undergoing Hip Arthroscopy for Acetabular Labral Treatment From Neighborhoods With Greater Socioeconomic Disadvantage Experience Worse Health Care Accessibility, Inferior Midterm Functional Outcomes, and Similar Rates of Conversion to Total Hip Arthroplasty"],"prefix":"10.1002","volume":"41","author":[{"given":"Jonathan S.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Gillinov","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bilal S.","family":"Siddiq","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kieran S.","family":"Dowley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit R.","family":"Rachala","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan J.","family":"Cherian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."},{"name":"Department of Orthopaedic Surgery University of Nebraska Omaha Nebraska U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher T.","family":"Eberlin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."},{"name":"Department of Orthopaedic Surgery University of Iowa Iowa City Iowa U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Kucharik","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts U.S.A."},{"name":"Department of Orthopaedic Surgery University of South Florida Tampa Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston Massachusetts 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