The effects of social determinants of health on anterior cruciate ligament injury recovery

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2024-07-18 DOI:10.1016/j.jor.2024.07.012

Luke Troyer , Aaron Voshage , Kylee Rucinski , Steven DeFroda , James L. Cook

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引用次数: 0

Abstract

Context

Over 200,000 anterior cruciate ligament (ACL) injuries occur in the United States each year. While many patients choose to pursue ACL reconstruction (ACLR), the impact of social determinants of health (SDOH) on outcomes is unclear.

Objective

The purpose of this study was to review and synthesize current literature to determine the impact of SDOH on outcomes following ACL reconstruction.

Data sources

A systematic search of PubMed, CINAHL, Medline, PsychINFO, and Scopus was completed.

Study selection

Articles reporting outcomes following ACLR were included if they discussed at least one SDOH and provided ACLR failure rates.

Study design

Systematic review.

Level of evidence

Level I.

Results

After screening 712 studies, 13 were found that met inclusion criteria and were analyzed. Studies commonly examined the correlations between race, income, location, education, and insurance on outcomes following ACLR. Three studies found that the ACL revision risk for Black patients compared to White patients ranged from 0.23 to 0.78, while the revision risk for Hispanic patients compared to White patients ranged from 0.7 to 0.83. One study reported finding that the odds ratio of revision for the White patients was 1.32. Another study reported no difference in revision risk based on race. Patients living in urban areas were found to have improved outcomes compared to rural areas (Mean IKDC (Urban 85.3 vs Rural 81.87) and Tegner-Lysholm (Urban 88.26 vs Rural 84.82)). Lower socioeconomic status was correlated with decreased post-operative functional scores (KOOS, Marx and IKDC).

Conclusion

Several SDOH such as White race, rural location, and low socioeconomic status may be independently correlated with worse ACLR outcomes in the form of increased revision rates or worse post-operative functional scores. However, further research is needed to better elucidate the degree of impact and interconnectedness of SDOH domains on ACLR patient outcomes.

查看原文本刊更多论文

健康的社会决定因素对前十字韧带损伤恢复的影响

背景美国每年有超过 20 万例前十字韧带 (ACL) 损伤。虽然许多患者选择进行前交叉韧带重建（ACLR），但健康的社会决定因素（SDOH）对治疗效果的影响尚不明确。本研究旨在回顾和综合当前文献，以确定 SDOH 对前交叉韧带重建后治疗效果的影响。数据来源对PubMed、CINAHL、Medline、PsychINFO和Scopus进行了系统检索。研究选择报道前交叉韧带重建术后结果的文章，如果至少讨论了一种SDOH并提供了前交叉韧带重建术的失败率，则被纳入研究。研究通常考察种族、收入、地点、教育程度和保险对前交叉韧带置换术后结果的相关性。三项研究发现，黑人患者与白人患者相比，前交叉韧带翻修风险从 0.23 到 0.78 不等，而西班牙裔患者与白人患者相比，前交叉韧带翻修风险从 0.7 到 0.83 不等。一项研究报告发现，白人患者的翻修几率比为 1.32。另一项研究报告称，不同种族的患者翻修风险没有差异。研究发现，与农村地区相比，城市患者的治疗效果更好（IKDC 平均值（城市 85.3 vs 农村 81.87）和 Tegner-Lysholm 平均值（城市 88.26 vs 农村 84.82））。较低的社会经济地位与术后功能评分（KOOS、Marx 和 IKDC）的降低相关。结论白种人、农村地区和较低的社会经济地位等一些 SDOH 可能与较差的 ACLR 结果独立相关，表现为翻修率增加或术后功能评分降低。然而，要更好地阐明 SDOH 领域对 ACLR 患者预后的影响程度和相互关联性，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.