Disparities in sports medicine care — the pediatric ACL

MRI Sagittal view of left knee in a pediatric patient with an ACL tear

As 2020 winds down I want to bring to the attention of the blog readers a particularly important study published in our last edition of the year.  In our November 2020 issue you will find:  How do race and insurance status affect the care of pediatric anterior cruciate ligament injuries?

The group of authors hails from Children’s Hospital of Philadelphia (CHOP), which routinely vies for the top spot as best pediatric hospital in the U.S. 

Physicians from my home institution of Nationwide Children’s Hospital take a knee to protest racism June 2020

In a year like no other, 2020 saw the news dominated not just by the novel COVID pandemic but a pandemic much much older and more persistent: structural racism.  Around the world, sparked by incidents in the US in late May 2020, there was a passionate outcry from all segments of society, including the medical community, about this insidious problem.

The issues that are being discussed with renewed vigor are old, but the energy and insight surrounding this current moment feel anything but.

There have been multiple commentaries on the intersectionality of health care, race, and the pandemic — this recent NY Times article, entitled How Black People Learned not to Trust, is particularly of the moment as the COVID vaccines are being rolled out worldwide.

In the universe that is the global community and the galaxy that is medicine, our smaller solar system of sports medicine is engaging in these same conversations.  And this new CHOP study adds to the abundant literature that race, and insurance status (private vs. public in the US), have highly significant and negative impacts on health care outcomes.

Pediatric ACL ruptures and their surgical treatment are shown in this study to be like any number of other, already well-documented health care issues, where under-represented minorities can expect in general worse outcomes than someone like me: a white male who has ‘good’ health insurance.

On a final note, I want to add that I take special pride in seeing the names of the authors on this study, among them surgeons Neeraj Patel and Ted Ganley, both members of the Pediatric Research in Sports Medicine (PRiSM) society, of which I am a member as well.  If you have an interest in pediatric sports medicine, by all means check out the upcoming virtual annual PRiSM conference January 28 – 30.  

So, check out the study, and until the next post: Happy Holidays!

About sportingjim
I work at Nationwide Children's Hospital in Columbus, Ohio USA, where I am a specialist in pediatric sports medicine. My academic appointment as an Associate Professor of Pediatrics is through Ohio State University. I am a public health advocate for kids' health and safety. I am also the Deputy Editor for the Clinical Journal of Sport Medicine.

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