{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:32Z","timestamp":1791740792734,"version":"4.3.4"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Social determinants of health (SDOH) may influence outcomes after total elbow arthroplasty (TEA), but associations with long-term implant-related complications are unclear. We evaluated the relationship between documented SDOH and: (1) 2-year implant-related complications after primary TEA; and (2) discharge disposition and 90-day health care utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective matched cohort study was performed using a national insurance claims database (2010-2021). Primary TEA patients with 2 years or more of continuous follow-up were included. Social determinants of health exposure was defined using International Classification of Diseases, Ninth and Tenth Revision codes. Social determinants of health patients (N\u2009=\u2009342) were matched 1:5 to controls (N\u2009=\u20091683) by age, sex, and overall Elixhauser Comorbidity Index. The outcomes evaluated included 2-year implant-related complications, non-home discharges, 90-day emergency department (ED) visits, and readmissions. Multivariable logistic regression computed odds ratios (ORs) of each outcome with 95% CIs. Significance was set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Social determinants of health exposure was associated with higher odds of 2-year infection (OR, 2.01; 95% CI, 1.35-2.94;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0004) and elbow stiffness (OR, 1.74; 95% CI, 1.22-2.43;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001), with no significant differences in revision or other implant-related complications. Social determinants of health exposure was associated with higher odds of non-home discharges (OR, 1.82; 95% CI, 1.15-2.82;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.008), while 90-day ED visits and readmissions were not significantly different between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Documented SDOH were associated with increased 2-year infection and stiffness after TEA and higher odds of non-home discharges, without increased revision risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>III<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447261489335","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:48:43Z","timestamp":1791463723000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Social Determinants of Health Are Associated With 2-Year Implant Complications Following Total Elbow Arthroplasty"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2760-0172","authenticated-orcid":false,"given":"Adam M.","family":"Gordon","sequence":"first","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Said","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"},{"name":"SUNY Downstate Health Sciences University, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick P.","family":"Nian","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"},{"name":"SUNY Downstate Health Sciences University, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murad","family":"Ruzzak","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"},{"name":"SUNY Downstate Health Sciences University, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Choueka","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.11.005"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2013.784658"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.00164"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-25-00473"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.23.01171"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-017-2687-x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.11.014"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01128"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.0621"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-023-05045-z"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2024.10.106"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.06.017"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/18632521251367969"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/bsd.0000000000002006"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.11.019"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.02.017"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-17-00410"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/corr.0000000000003665"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2025.03.028"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.12538"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2024.04.013"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.23.00044"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002394"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001168"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-023-05186-1"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.12.033"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000003818"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447261489335","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15589447261489335","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447261489335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:09:22Z","timestamp":1791738562000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15589447261489335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":27,"alternative-id":["10.1177\/15589447261489335"],"URL":"https:\/\/doi.org\/10.1177\/15589447261489335","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"article-number":"15589447261489335"}}