title: The influence of area level social deprivation on preoperative disease severity and postoperative outcomes following unicompartmental knee joint replacement.
abstract: BACKGROUND
  This study investigated the effect of socioeconomic deprivation on preoperative disease and outcome following unicompartmental knee replacement (UKR).
  
  
  METHODS
  307 Oxford UKRs implanted between 2008 and 2013 under the care of one surgeon using the same surgical technique were analysed. Deprivation was quantified using the Northern Ireland Multiple Deprivation Measure. Preoperative disease severity and postoperative outcome were measured using the Oxford Knee Score (OKS).
  
  
  RESULTS
  There was no difference in preoperative OKS between deprivation groups. Preoperative knee range of motion (ROM) was significantly reduced in more deprived patients with 10° less ROM than least deprived patients. Postoperatively there was no difference in OKS improvement between deprivation groups (p=0.46), with improvements of 19.5 and 21.0 units in the most and least deprived groups respectively. There was no significant association between deprivation and OKS improvement on unadjusted or adjusted analysis. Preoperative OKS, Short Form 12 mental component score and length of stay were significant independent predictors of OKS improvement. A significantly lower proportion of the most deprived group (15%) reported being able to walk an unlimited distance compared to the least deprived group (41%) one year postoperatively.
  
  
  CONCLUSIONS
  More deprived patients can achieve similar improvements in OKS to less deprived patients following UKR.
authors.affiliation: Public Health Agency, 12-22 Linenhall Street, Belfast BT2 8BS, Northern Ireland, United Kingdom; Primary Joint Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland, United Kingdom; Centre for Public Health, Queens University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, United Kingdom. Electronic address: damien.bennett.mph@hotmail.com.
authors.forename: Damien
authors.initials: D
authors.lastname: Bennett
authors.affiliation: Primary Joint Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland, United Kingdom.
authors.forename: Janet
authors.initials: J
authors.lastname: Hill
authors.affiliation: Primary Joint Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Beverland
authors.affiliation: Centre for Public Health, Queens University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, United Kingdom.
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011184:Postoperative Period; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Postoperative outcomes; Social deprivation; Unicompartmental knee joint replacement