Abstract
INTRODUCTION: Hip arthroscopy (HA) is increasingly used to treat femoroacetabular impingement (FAI) and labral tears, with growing interest in the role of socioeconomic factors on postoperative outcomes. Prior literature suggests socioeconomic deprivation may worsen patient-reported outcomes (PROMs), but findings regarding the Area Deprivation Index (ADI) and urbanization status remain inconsistent. This study aimed to evaluate the difference in PROMs after HA secondary to symptomatic FAI and hip labral tears based on the residential urbanization status, demographic variables, and Area Deprivation Index (ADI) values of patients in our single-center cohort. METHODS: A single-institution retrospective review was conducted on 86 patients who underwent HA between 2014 and 2023. Patients were categorized as urban or rural based on U.S. Census data and assigned national/state ADI scores based on their residential addresses. PROMs (mHHS, HOS-ADL, HOS-Sport, NAHS) were collected via telephone survey at ≥1 year postoperatively. Statistical comparisons and multivariable regression analyses were used to assess the impact of demographic variables and ADI on PROMs. RESULTS: There were no significant differences in PROMs between urban and rural patients. However, regression analysis revealed that national ADI and age were significantly negatively correlated with all PROMs (p < 0.05). Older age and higher ADI independently predicted worse postoperative outcomes. Interaction effects, such as age × BMI or age × ADI, also negatively influenced certain PROMs. Race and surgical indication showed limited interaction effects. CONCLUSION: While urbanization status did not impact outcomes, higher socioeconomic deprivation (as measured by national ADI) and increased age were associated with significantly worse PROMs after HA at 1-year follow-up. These findings suggest that neighborhood-level socioeconomic disadvantage plays a more critical role than urban-rural classification in influencing recovery. Strategies aimed at addressing social determinants of health may improve HA outcomes, particularly in socioeconomically disadvantaged populations.