Home ownership, full-time employment, and other markers of higher socioeconomic status are predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction

• Published in: Knee surgery & related research 2023-07, Vol.35 (1), p.20-20, Article 20
• Main Authors: Shankar, Dhruv S, Avila, Amanda, DeClouette, Brittany, Vasavada, Kinjal D, Jazrawi, Isabella B, Alaia, Michael J, Gonzalez-Lomas, Guillem, Strauss, Eric J, Campbell, Kirk A
• Format: Article
• Language: English
• Subjects: Bone surgery; Data collection; Education; Electronic health records; Employment; Family income; Home ownership; Knee; Ligaments; Magnetic resonance imaging; Medical records; Medicine; MPFL; Neighborhoods; Orthopedics; Patellar instability; Patient-reported outcomes; Patients; Postoperative period; Return; Socioeconomic; Socioeconomic factors; Socioeconomic status; Sports medicine; Surgeons; Time to surgery; Workloads
• ISSN: 2234-0726; 2234-2451; 2234-2451
• DOI: 10.1186/s43019-023-00193-3

The purpose of this study was to identify socioeconomic predictors of time to initial evaluation, time to surgery, and postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction (MPFLR). We conducted a retrospective review of patients at our institution who underwent primary MPFLR with allograft from 2011 to 2019 and had minimum 12-month follow-up. Patients were administered an email survey in January 2022 to assess symptom history, socioeconomic status, and postoperative outcomes including VAS satisfaction and Kujala score. Predictors of time to initial evaluation, time to surgery, and postoperative outcomes were identified using multivariable linear and logistic regression with stepwise selection. Seventy patients were included in the cohort (mean age 24.8 years, 72.9% female, mean follow-up time 45.7 months). Mean time to evaluation was 6.4 months (range 0-221) and mean time to surgery was 73.6 months (range 0-444). Having a general health check-up in the year prior to surgery was predictive of shorter time to initial evaluation (β = - 100.5 [- 174.5, - 26.5], p = 0.008). Home ownership was predictive of shorter time to surgery (β = - 56.5 [- 104.7, 8.3], p = 0.02). Full-time employment was predictive of higher VAS satisfaction (β = 14.1 [4.3, 23.9], p = 0.006) and higher Kujala score (β = 8.7 [0.9, 16.5], p = 0.03). Markers of higher socioeconomic status including having a general check-up in the year prior to surgery, home ownership, and full-time employment were predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes.  IV, retrospective case series.