Search Filters

  • Media Source
  • Presentation Format
  • Media Type
  • Media Year
  • Language
  • Diagnosis / Condition
  • Diagnosis Method
  • Patient Populations
  • Treatment / Technique

No Evidence of Racial Disparities in Revision Risk Following ACL Reconstruction in a Single Healthcare Network Despite Increased Social Disadvantage Among Black Patients

2023 Congress Paper Abstracts
myRating

No Evidence of Racial Disparities in Revision Risk Following ACL Reconstruction in a Single Healthcare Network Despite Increased Social Disadvantage Among Black Patients

Ian DeYoe Engler, MD, UNITED STATES Sahil Dadoo, BS, UNITED STATES William T. Li, MD, UNITED STATES Robert Tisherman, UNITED STATES Audrey Y. Chang, BA, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES

UPMC Department of Sports Medicine, Pittsburgh, Pennsylvania, UNITED STATES


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Diagnosis / Condition

Treatment / Technique

Anatomic Location


Summary: There were no detected differences in revision risk following ACL reconstruction between Black and White patients despite a significantly higher area deprivation index (ADI) score, indicating increased social disadvantage, reflecting the importance of considering and addressing social disparities and possible implications on health outcomes.


Purpose

To compare the revision surgery risk following anterior cruciate ligament (ACL) reconstruction between black and white patients in a single healthcare network.

Methods

All primary ACL reconstructions at a single large healthcare network between 2015-2020 with minimum two-year follow-up and in patients of Black or White race were included. Patient demographics, surgical details, and return to operating room were retrospectively collected. Area deprivation index (ADI), a composite metric representing social disadvantage of communities by Census Block Group, was obtained for each patient. ADI is scored from 0-100%, with 100% demarking the most disadvantaged communities. The primary outcome was revision ACL reconstruction, and the secondary outcome was future ACL surgery in either knee (combined revision ipsilateral ACL reconstruction or any contralateral ACL surgery). Analysis was done using t-tests and Chi square tests to compare rates of revision surgery between Black and White patients. Significance was set at P < 0.05.

Results

A total of 3,183 ACL reconstructions were included in the study, of which 351 (11.5%) were Black patients. The mean age was 23.1 +/- 9.2 years in Black patients and 26.4 +/- 12.0 years in White patients (p < 0.001). Black patients had a significantly higher ADI than White patients 72 vs 60; p < 0.001. White patients had a higher proportion of isolated ACL reconstructions than Black patients (55% vs 43.6% respectively; p < 0.001), whereas Black patients had a higher proportion of ACL reconstruction and concomitant meniscus surgery (54% vs 44%; p < 0.001). Black patients did not have a higher rate of revision ACL reconstruction (3.1% vs 2.3%; p = 0.355) or future ACL surgeries (6.0% vs 4.4%; p = 0.197).

Conclusions

There was no detected difference in the rate of revision ACL reconstruction between Black and White patients at two-year follow-up even though Black patients had a significantly higher ADI. Despite no detected difference in these outcomes, the substantial difference in ADI between races highlights the continued need to address social disparities between Black and White patients and therefore the potential associated implications on other health outcomes.


More 2023 ISAKOS Congress Content