Socioeconomic Area Deprivation is Related to Poorer Patient-Reported Outcomes Following Autologous Chondrocyte Implantation (ACI).

Abstract

ObjectiveTo determine the association between socioeconomic deprivation and short-term patient-reported clinical outcomes following autologous chondrocyte implantation (ACI).DesignAll patients receiving knee ACI between 1996 and 2020 in our center were identified. Socioeconomic deprivation of their residential area was quantified using the Index of Multiple Deprivation (IMD). Patient-reported 1-year Lysholm and Intermittent and Constant Osteoarthritis Pain (ICOAP) scores were used as outcome measures in the analyses. After transformation to ensure normal distributions (where required), linear multivariable regression was used to analyze the relationship between IMD and 1-year Lysholm score, adjusting for demographic characteristics (age, sex, body mass index [BMI], and smoking) and baseline Lysholm.ResultsThree hundred and ninety-one patients with a mean age of 50 years (range = 16-84; 266 male) were identified. Median BMI was 27 (17-47), with 138 patients overweight and 105 obese. Seventy-seven patients lived in upper and 41 in lower quintile deprivation areas. The mean baseline Lysholm score was 49.8 ± 17.3 SD, improving to 66.5 ± 21.3 SD at 1 year. Mean 1-year Lysholm scores were significantly lower with increasing area deprivation scores, adjusted for demographic factors. Specifically, areas with high unemployment levels, being female, or having a lower baseline Lysholm were associated with poorer outcomes, but age, BMI, smoking, or higher income deprivation were not.ConclusionThis study demonstrates poorer functional outcomes following ACI in patients from more deprived areas, indicating future studies should consider neighborhood deprivation as a confounding factor. Furthermore, targeting patients from areas with higher deprivation with additional interventions/community support may improve their outcomes.