Mapping the Representation of Race and Other Health Disparities in U.S. Orthopaedic Journals

Background Although interest in health disparities has expanded across medicine, the extent to which race and other social determinants of health are represented in orthopaedic research is unclear. Orthopaedics has traditionally emphasized biomechanical and procedural outcomes rather than structural or social drivers of inequity. This study maps how race and other determinants-gender, socioeconomic status, geography, and insurance-are represented within U.S. orthopaedic surgery journals. Methods A scoping review was performed following PRISMA-ScR guidelines. Searches in PubMed, Embase, Cochrane CENTRAL, CINAHL, Scopus, and Web of Science (2014-2024) identified orthopaedic publications addressing health disparities. Eligible articles analysed or reported variables such as race, ethnicity, sex/gender, socioeconomic status, geography, or insurance. Two reviewers independently screened and charted data. Results Among more than 180,000 articles across sixty-nine orthopaedic journals, 333 (<0.5 per cent) met inclusion criteria. Race/ethnicity appeared most frequently (94 per cent), followed by sex/gender (77 per cent), insurance (39 per cent), socioeconomic status (29 per cent), and geography (24 per cent). Nearly half of the included articles were published in 2022 or later. Of race-related articles, 58 per cent included race only as a demographic descriptor, while 42 per cent analysed race as a primary focus. Conclusion Despite recent growth, health disparities remain minimally represented in orthopaedic literature, with most studies using race descriptively rather than examining structural inequity. Greater engagement with social determinants is needed to advance equitable musculoskeletal care and uphold core bioethical principles.