BACKGROUND: Sociodemographic determinants of health impact treatment pathways across medical specialties, including orthopedics. This study aimed to investigate the effect of these factors on the treatment and outcomes of end-stage ankle arthritis.

METHODS: This retrospective, cross-sectional study, used ICD 9/10 to identify 3,219 patients (≥ 18 years) between 2011-2021, with end-stage ankle arthritis, of which 509 patients were included in the final sample. Race, ethnicity, spoken language and gender were noted. The type of treatment, postoperative complication rates, and reoperation rates were compared using Chi-square test. Linear regression models determined if the sociodemographic variables affected the time gap between initial consultation and surgical treatment, and duration of hospital stay. P<0.05 was considered statistically significant.

RESULTS: 87.82% patients were white, 94.3% were non-Hispanic, 94.7% spoke English and 53.4% were female. For whites and non-whites, non-Hispanics and Hispanics, English and non-English speakers, the difference in the proportion receiving nonoperative treatment was not statistically significant; but for males and females, p = 0.002. Hispanic ethnicity significantly predicted the time gap between the diagnosis of end-stage ankle arthritis and surgical treatment (p=0.021) and non-English language predicted the hospital stay duration (p=0.010).

CONCLUSION: Females were more often treated conservatively, non-English speakers were likely to have lengthened hospital stays, and Hispanic patients had delayed surgical treatment. Thus, barriers to care still exist, warranting additional research.