Luke Troyer , Aaron Voshage , Kylee Rucinski , Steven DeFroda , James L. Cook
{"title":"健康的社会决定因素对前十字韧带损伤恢复的影响","authors":"Luke Troyer , Aaron Voshage , Kylee Rucinski , Steven DeFroda , James L. Cook","doi":"10.1016/j.jor.2024.07.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Context</h3><p>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.</p></div><div><h3>Objective</h3><p>The purpose of this study was to review and synthesize current literature to determine the impact of SDOH on outcomes following ACL reconstruction.</p></div><div><h3>Data sources</h3><p>A systematic search of PubMed, CINAHL, Medline, PsychINFO, and Scopus was completed.</p></div><div><h3>Study selection</h3><p>Articles reporting outcomes following ACLR were included if they discussed at least one SDOH and provided ACLR failure rates.</p></div><div><h3>Study design</h3><p>Systematic review.</p></div><div><h3>Level of evidence</h3><p>Level I.</p></div><div><h3>Results</h3><p>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).</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24002800/pdfft?md5=ca59dfa6392f31278816cc822675cc39&pid=1-s2.0-S0972978X24002800-main.pdf","citationCount":"0","resultStr":"{\"title\":\"The effects of social determinants of health on anterior cruciate ligament injury recovery\",\"authors\":\"Luke Troyer , Aaron Voshage , Kylee Rucinski , Steven DeFroda , James L. Cook\",\"doi\":\"10.1016/j.jor.2024.07.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Context</h3><p>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.</p></div><div><h3>Objective</h3><p>The purpose of this study was to review and synthesize current literature to determine the impact of SDOH on outcomes following ACL reconstruction.</p></div><div><h3>Data sources</h3><p>A systematic search of PubMed, CINAHL, Medline, PsychINFO, and Scopus was completed.</p></div><div><h3>Study selection</h3><p>Articles reporting outcomes following ACLR were included if they discussed at least one SDOH and provided ACLR failure rates.</p></div><div><h3>Study design</h3><p>Systematic review.</p></div><div><h3>Level of evidence</h3><p>Level I.</p></div><div><h3>Results</h3><p>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).</p></div><div><h3>Conclusion</h3><p>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.</p></div>\",\"PeriodicalId\":16633,\"journal\":{\"name\":\"Journal of orthopaedics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-07-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0972978X24002800/pdfft?md5=ca59dfa6392f31278816cc822675cc39&pid=1-s2.0-S0972978X24002800-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of orthopaedics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0972978X24002800\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0972978X24002800","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The effects of social determinants of health on anterior cruciate ligament injury recovery
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.
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.
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