{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:25:18Z","timestamp":1787300718559,"version":"build-2736575974"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"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":["Shoulder &amp; Elbow"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Total shoulder arthroplasty (TSA) is an effective treatment for glenohumeral osteoarthritis (GHOA), with utilization increasing over time. While prior studies have examined racial and ethnic disparities, the impact of broader social determinants of health (SDOH) on TSA utilization and outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The TriNetX database was used to identify patients with GHOA and stratify them by SDOH disparities. Patients were matched 1:1 using propensity scores. The primary outcome was TSA utilization within 5 years. Secondary outcomes included 90-day and 1-year postoperative complications. Bonferroni correction was applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 84,767 patients were included per utilization cohort. TSA utilization was higher in patients without SDOH disparities (5.78% vs. 3.14%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The complications cohorts included 2071 patients each. The SDOH cohort had higher rates of emergency department visits and cardiac events at 90 days and 1 year (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). At 1 year, acute kidney injury, urinary tract infection, pneumonia (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and pulmonary embolism (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002) were also higher. Mechanical complications were higher at 1 year on unadjusted analysis only. Revision, periprosthetic joint infection, and fracture rates were similar.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SDOH disparities are associated with lower TSA utilization and increased postoperative medical complications, suggesting disparities in access to care and healthcare utilization rather than surgical durability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17585732261476678","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T18:19:46Z","timestamp":1787077186000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Social determinants of health disparities are associated with lower total shoulder arthroplasty utilization and increased medical complications: A propensity-matched analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6998-2025","authenticated-orcid":false,"given":"Arsen M","family":"Omurzakov","sequence":"first","affiliation":[{"name":"Weill Cornell Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argen","family":"Omurzakov","sequence":"additional","affiliation":[{"name":"Case Western Reserve University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousi","family":"Oquendo","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex E","family":"White","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua S","family":"Dines","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella E","family":"Ode","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M","family":"Dines","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence V","family":"Gulotta","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M","family":"Brusalis","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle E","family":"Kew","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel A","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-21-00302"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.08.010"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.10.023"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2022.08.008"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2023.11.008"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2023.07.006"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-015-0138-3"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20160427-14"},{"key":"e_1_3_2_10_2","unstructured":"CDC. Social determinants of health (SDOH). CDC https:\/\/www.cdc.gov\/about\/priorities\/why-is-addressing-sdoh-important.html (2024 accessed 20 February 2025)."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.08.024"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003829"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/00333549141291S206"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/15563316231195299"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-19-00490"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2018.12.028"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2024.04.020"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.2340\/17453674.2024.42700"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2024.08.013"}],"container-title":["Shoulder &amp; Elbow"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17585732261476678","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17585732261476678","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17585732261476678","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T07:58:38Z","timestamp":1787299118000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17585732261476678"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":18,"alternative-id":["10.1177\/17585732261476678"],"URL":"https:\/\/doi.org\/10.1177\/17585732261476678","relation":{},"ISSN":["1758-5732","1758-5740"],"issn-type":[{"value":"1758-5732","type":"print"},{"value":"1758-5740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]},"article-number":"17585732261476678"}}