Evidence map›Paper›PMID 42544910›Full record

ArticleThe American journal of sports medicine2026

Sociodemographic Predictors of Postpresentation Delay to Pediatric ACL Reconstruction and Associated Intra-articular Injury Severity.

Christopher D Hamad, Shannon Wu, Kole Joachim, Esther Chung, Timothy Liu, Mauricio Silva, Richard Bowen, Soroush Baghdadi

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Article in The American journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Christopher D HamadDepartment of Orthopaedic Surgery, University of California, Los Angeles, California, USA.ORCID 0000-0002-8896-9857
Shannon WuDepartment of Orthopaedic Surgery, University of California, Los Angeles, California, USA.
Kole JoachimDavid Geffen School of Medicine at UCLA, Los Angeles, California, USA.ORCID 0000-0002-3584-6976
Esther ChungUniversity of California, Los Angeles, Los Angeles, California, USA.
Timothy LiuDepartment of Orthopaedic Surgery, University of California, Los Angeles, California, USA.
Mauricio SilvaDepartment of Orthopaedic Surgery, University of California, Los Angeles, California, USA.
Richard BowenDepartment of Orthopaedic Surgery, University of California, Los Angeles, California, USA.
Soroush BaghdadiDepartment of Orthopaedic Surgery, University of California, Los Angeles, California, USA.ORCID 0000-0002-3401-2355

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDelayed anterior cruciate ligament reconstruction (ACLR) in pediatric patients is associated with progressive intra-articular injury. Although disparities in access to orthopaedic care have been reported, it remains unclear whether structural determinants of health influence postpresentation surgical delay and downstream functional recovery. PURPOSE: To determine whether sociodemographic and structural determinants are associated with prolonged postpresentation delay to pediatric ACLR and with intra-articular injury severity and postoperative functional outcomes. STUDY

designCohort study; Level of evidence, 3.

methodsThe records of 443 pediatric patients who underwent ACLR (2013-2025) at an urban academic referral center with a pediatric orthopaedic urgent care were reviewed. Exposures included race/ethnicity, insurance type, and neighborhood deprivation (Childhood Opportunity Index [COI]). Delay was defined as time from first orthopaedic presentation to surgery, with prolonged delay defined as >120 days. Outcomes included high-grade cartilage injury (Outerbridge grade 3 or 4), meniscal tear presence, failure to return to sport (≥365 days of follow-up), hop test symmetry, isometric strength symmetry, and graft failure. Multivariable regression models were adjusted for race/ethnicity, age, sex, insurance, and national COI.

resultsThe median time from injury to presentation was 5 days, while the median postpresentation time to surgery was 101 days; 38.6% experienced prolonged delay. In adjusted logistic regression, non-Hispanic Black, Hispanic, and other/unknown race/ethnicity; public insurance; and lower neighborhood opportunity were each independently associated with prolonged delay. Continuous postpresentation delay was independently associated with increased odds of high-grade cartilage injury (OR, 1.004 per day; 95% CI, 1.000-1.008;

conclusionDisparities in pediatric ACLR are driven primarily by postpresentation system-level delays and are associated with an incrementally greater risk of cartilage injury.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionTime-to-TreatmentAdolescentChildFemaleHealthcare DisparitiesHumansMaleRetrospective StudiesReturn to SportSocioeconomic Disparities in HealthTibial Meniscus InjuriesTreatment Delayaccess to carecartilage injuryChildhood Opportunity Indexhealth disparitiespediatric anterior cruciate ligamentreturn to sport

Identifiers

PMID42544910
PMCPMC13530331

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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.