Associations Between Race and Socioeconomic Status, Lower Extremity Strength, and Patient-Reported Outcomes Following Anterior Cruciate Ligament Reconstruction.

Abstract

Context: There are significant disparities in access to health care, but there are limited data about the impact of race and socioeconomic status on postoperative outcomes following anterior cruciate ligament reconstruction (ACLR) surgery.

Objective: To identify associations between the Area Deprivation Index (ADI), strength measures, and patient-reported outcomes following ACLR and examine differences in outcomes between race, sex, and socioeconomic status.

Design: Case-control study in a single hospital setting.

Setting: Database secondary analysis.

Patients or other participants: Data were collected from 340 patients who underwent primary, isolated, unilateral ACLR.

Main outcome measure(s): Strength measures and patient-reported outcomes were obtained at patients' postoperative assessments at approximately 6 months postsurgery. Area Deprivation Index values were calculated on each patient's census tract, as determined through medical records review. Correlations were conducted to determine the relationship between the ADI and Knee Injury and Osteoarthritis Outcome Score measures, International Knee Documentation Committee, and limb symmetry on strength measurements. The racial composition of the sample was heavily skewed and was excluded from statistical analyses.

Results: The ADI was weakly correlated with International Knee Documentation Committee (ρ = 0.11, P = .04) outcomes, with more disadvantaged patients reporting better quality of life and knee function. The ADI was not correlated with other outcomes of interest. The median ADI value of the sample was 32 (range, 1-86 [interquartile range, 19-47]).

Conclusions: Our study revealed a weak correlation between higher levels of socioeconomic disadvantage as measured by the ADI and improved subjective assessment of knee function and quality of life as measured by International Knee Documentation Committee. These findings are contrary to what other studies on this subject have found and highlight the importance of further research into the impact of socioeconomic status and other social determinants of health on post-ACLR outcomes.