Abstract
BACKGROUND: Race, ethnicity, and social determinants of health (SDoH) are essential in achieving equitable access and care in patients with total hip (THA) and total knee arthroplasty (TKA). Previous studies indicated the low prevalence of reporting SDoH and demographic factors in orthopaedic randomized control trials (RCTs). This study investigates updated trends in reporting the prevalence of patient demographics and SDoH in THA and TKA-related RCTs published between 2019 and 2024. METHODS: A systematic review of all PubMed-indexed journals relating to arthroplasty was conducted for all RCTs published between 2019 and 2024. Data on the publication year, type of surgery, inclusion of race, ethnicity, insurance, income, education, treatment or exposure, and measured outcomes were recorded. RESULTS: Of 391 studies, only 12 (3.1%) considered race, ethnicity, insurance, income, education, and employment in their research. Less than 2% of papers reported race. No significant differences were found between journal type, publication year, and type of surgery. Insurance, income, education, and/or employment were minimally reported (n = 6; 1.5%). The most common treatments or exposures in studies that included SDoH variables were related to postoperative management (n = 5) and analgesia/anesthesia protocol (n = 3). Commonly measured outcomes were pain and analgesia consumption (n = 6) and functional outcome (n = 4). CONCLUSION: Reporting on race, ethnicity, and SDoH in RCTs conducted in patients undergoing hip and knee total joint arthroplasty remains insufficient, and no improvements in reporting patterns have been observed over time when comparing the periods included in this study and previous literature. Including these variables in RCTs is of utmost importance to improve the quality of arthroplasty research and orthopaedic care for patients of all backgrounds.