ArticleJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews2026
Government Insurance and Higher Area Deprivation Index Associated With Increased Time to Care in Patients With Traumatic Patellar Instability.
Article in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 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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Abstract
introductionPatellar instability is an increasingly prevalent condition in the adolescent population, often requiring surgical intervention for traumatic or recurrent dislocations. Despite growing recognition of health disparities in orthopaedic surgery, little is known about sociodemographic factors associated with delays to care. We hypothesized that government insurance and higher Area Deprivation Index (ADI) would be associated with increased time to care.
methodsA retrospective review was conducted of pediatric patients (ages 7 to 19 years) undergoing surgery for traumatic patellar instability at a single institution from September 2015 to September 2022. Demographic characteristics, ADI scores, and time-to-care variables were collected including time to first visit, magnetic resonance imaging (MRI), and day of surgery. Multivariable linear regression analyses were conducted with sex, race, insurance status, and ADI as independent variables.
resultsA total of 118 patients were included (mean age 15.0 ± 2.0 years; 54.2% female). Higher ADI was significantly associated with longer time from injury to the first visit (β = 0.1, P = 0.042) and from the first visit to MRI (β = 1.9, P = 0.041). Government insurance was significantly associated with longer time from surgical decision to surgery (β = 24.6, P = 0.019). No notable associations were found for sex or race.
conclusionADI and public insurance are two sociodemographic factors associated with delays to care for pediatric patients treated with surgery after traumatic patellar instability. Longer care journeys in this population may affect patients' quality of life. Additional efforts are warranted to mitigate these potential health disparities and ensure more equitable care delivery.
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