CJSM Podcast: The effect of race and insurance status on ACL injury outcomes in children and adolescents

January 18, 2021 by

ACL injuries are a common subject for sports medicine publications:  according to a 2019 study in the Orthopaedic Journal of Sports Medicine, there have been 18,696 ACL publications in PubMed during the past 40 years, trending upwards from 26 articles published in 1979 to 1380 articles published in the year 2018 alone.

The reasons for this are clear. ACL injuries are a common injury in the young and physically active, and the ligament itself is the most commonly operated ligament of the knee.  The injury is consequential, both in its impact on athletic performance as well as on long-term morbidity, with a well-known risk of early onset osteoarthritis which can cause long-term pain, functional limitations, and decreased quality of life.

Another phenomenon also all too common in American medicine is that of health care disparities.  You name the disease or injury in medicine and the therapy or intervention in question, and dollars to donuts you’ll find a study showing that race, ethnicity, and socioeconomic status can have negative consequences on outcomes.

A new study in the November 2020 CJSM looks at the intersection of these two common phenomena, and reports on the impact of race and insurance status (a proxy for socioeconomic status) on outcomes in the care of pediatric ACL injuries. As soon as I finished reading the study, I wrote a blog post.

I also knew whom I had to have on as the next guest for the CJSM podcast.

Neeraj Patel M.D., M.P.H. performing knee arthroscopy in the O.R.

Neeraj Patel M.D., M.P.H., corresponding author of the study — How do race and insurance status affect the care of pediatric anterior cruciate ligament injuries — is an attending physician at Lurie Children’s Hospital in Chicago, USA and an Assistant Professor of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine. He joined me one morning to do a deeper dive into the work he and his team from Children’s Hospital of Philadelphia (CHOP) did to bring this excellent study to the pages of CJSM.

Dr. Patel and the senior author, Dr. Ted Ganley, are both members of the Pediatric Research in Sports Medicine Society (PRiSM), which I have profiled in previous blog posts.  PRiSM is conducting its annual meeting January 28 – 30 and, not surprisingly in this COVID era, it is taking place virtually.  By all means attend if you can to hear from researchers like Dr. Patel.

Also, go now to the the study itself in CJSM.  And finally, as ever you can subscribe to our CJSM podcasts at iTunes or go to the journal website and find this podcast with Dr. Patel and all of our podcasts.

Filed under CJSM Podcasts, General Interest, Public Health in Sports and Exercise Medicine Tagged with

CJSM Blog Journal Club — Preinjury & Postinjury Factors Predicting Recovery in Sports-related Concussions

January 4, 2021 by

The new year is upon us, and the first issue of the 2021 Clinical Journal of Sports Medicine has published.

There is much to commend in the issue.  It is always difficult to pick one manuscript among many to highlight in the CJSM Blog Journal club (that’s a good ‘problem’ to have).  

This month, our Jr. Associate Editor Jason L Zaremski, MD has decided to evaluate an original research article looking at pre- and post-injury risk factors that affect clinical recovery time in sport-related concussions.

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Jr. Associate Editor Jason L Zaremski MD

Jason L Zaremski, MD

Introduction:  As we finish up a fall sport season that has been like no other and begin 2021 with renewed spirit, the editors of CJSM and the CJSM blog journal club would like to take a moment to thank all of the health care professionals working tirelessly to keep all of our athletes, patients, support staff, and family members safe. We are proud of how the sports medicine community has conducted itself during this pandemic, and we are hopeful that vaccination will allow us to put this pandemic in the rear view mirror in the not-too-distant future.

To kick off 2021 we would like to review a wonderful manuscript from a team headed by Margot Putukian, M.D., past-president of the AMSSM, which analyzes preinjury and post-injury factors that predict sports-related concussion and clinical recovery time.

Purpose/Specific Aims:

1) The authors evaluated a possible relationship between preinjury risk factors (RFs) and resultant occurrence of concussion.

2) They also sought to examine whether preinjury RFs or post-injury assessments predicted clinical recovery in collegiate athletes

  • defined as days until symptom-free (DUSF) and days until full return to play (DUFRTP)

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Filed under Concussion in Sport, General Interest