ArticleJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews2025
Decrease in Pediatric Anterior Cruciate Ligament Injury-related Care Disparities for Medicaid Patients From 2015 to 2020.
Article in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
introductionAnterior cruciate ligament (ACL) injuries are relatively common in the pediatric population, and ACL reconstruction (ACLR) followed by postoperative physical therapy (PT) is frequently considered to decrease the risk of additional knee injury and improve functional outcomes. Disparities across insurance groups in ACL surgical rates and PT utilization have been previously reported, but there is limited analysis from national databases, and even less about disparity trends over time.
methodsThe 2015 to 2020 M157 PearlDiver database was queried for patients younger than 18 years diagnosed with ACL injury with commercial or Medicaid insurance. Factors abstracted included year, insurance plan, ACLR or not, and PT utilization and number of visits. The incidence of ACLR and PT visits were compared across insurance groups by year.
resultsIn total, 61,333 ACL injuries were identified for which ACLR was done for 21,083 (34.4%). The incidence of reconstruction was higher for those with commercial than Medicaid (35.0% vs. 30.7%, P < 0.001). Over the years of the study, this gap decreased from 7.7% in 2015 (P < 0.001) to 0.7% in 2020 (P = 0.714). For postoperative patients, those with commercial insurance had more PT sessions (26.45 vs. 22.53, P < 0.001). This gap decreased from 6.48 sessions in 2015 (P < 0.001) to 4.07 sessions in 2020 (P = 0.002). For nonsurgical patients, those with commercial insurance were more likely to receive PT (43.3% vs. 39.8%, P < 0.001) and to receive more sessions (18.76 vs. 14.35, P < 0.001). The gap in PT incidence deceased from 9.7% in 2015 (P < 0.001) to 2.4% in 2020 (P = 0.200).
conclusionMedicaid pediatric patients with ACL injuries were markedly less likely to undergo reconstruction and received less PT than commercial insurance patients, but these differences decreased/disappeared over the years studied. It is reassuring to see these insurance-related disparities decreasing over time, and continued access efforts are needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.