Background
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).
Methods
We conducted a retrospective review of patients at our institution who underwent primary MPFLR with allograft from 2011 to 2019. Patients’ medical records were reviewed, and they were also administered an email survey to assess symptom history, socioeconomic variables (ex. language, race, ethnicity, marital status, household size), and postoperative outcomes including Visual Analog Scale (VAS) pain, Kujala score, MPFL-Return to Sport After Injury (MPFL-RSI) score, and return to work and sport. Predictors of time to initial evaluation, time to surgery, concomitant procedures, and postoperative outcomes were identified using multivariable linear and logistic regression with stepwise selection. P-values less than 0.05 were considered significant.
Results
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). Home ownership was predictive of reduced time to surgery (?: -56.5 [-104.7 to -8.3]; p = 0.02). Non-white race was predictive of increased odds of undergoing a concomitant procedure (OR: 12.4 [1.8 to 83.4]; p = 0.01). Full-time employment was predictive of higher satisfaction (?: 14.1 [4.3 to 23.9]; p = 0.006) and higher Kujala score (?: 8.7 [0.9 to 16.5]; p = 0.03).
Conclusion
Certain markers of higher socioeconomic status including home ownership and full-time employment were predictive of higher satisfaction and knee function following MPFLR for patellar instability and non-white race was associated with higher odds of undergoing concomitant procedures.