Does Surgery for Cruciate Ligament and Meniscus Injury Increase the Risk of Comorbidities at 2 Years in the Military System?

Cook, Chad; Sheean, Andrew J.; Zhou, Liang; Min, Kyong S.; Rhon, Daniel I.

doi:10.1055/s-0041-1736197

Cited by 2 publications

(12 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After adjusting for baseline covariates, a protective effect was found by our authorship group 18 for individuals undergoing isolated meniscus surgery which led to fewer instances of concussion, insomnia, other mental health disorders, depression, and substance abuse. We 18 also found that surgery had no increased or decreased risk for development of comorbidities after cruciate ligament injury. To date, we are unaware of any reports that have sought to investigate the risks of comorbidities in concurrent cruciate and meniscus injuries.…”

mentioning

confidence: 72%

“…Similar comorbidity counts were used previously. 18 By adjusting dates of pre- and post-index events (diagnosis vs. surgery), we were able to more accurately represent 12 months prior and 24 months after the designated times of interest (i.e., nonsurgical diagnosis and surgery). To be included as a comorbidity, a patient required a minimum of two distinctive documented medical visits that resulted in a specific comorbidity diagnosis (ICD-9 codes) 21 before or after the index date.…”

Section: Methodsmentioning

confidence: 99%

“…18 This is important since the risk for many comorbidities increases when changes in activity levels and lifestyle occur after the treatment. After adjusting for baseline covariates, a protective effect was found by our authorship group 18 for individuals undergoing isolated meniscus surgery which led to fewer instances of concussion, insomnia, other mental health disorders, depression, and substance abuse. We 18 also found that surgery had no increased or decreased risk for development of comorbidities after cruciate ligament injury.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Does Surgery for Concomitant Cruciate and Meniscus Injuries Increase or Decrease Subsequent Comorbidities at 2 Years?

et al. 2022

Self Cite

View full text Add to dashboard Cite

Concomitant cruciate and meniscus injuries of the knee are generally associated with acute trauma and commonly treated with surgical intervention. Comorbidities (simultaneous presence of two or more medical conditions) may be acquired from changes in activity levels and lifestyle after an injury and/or treatment. This study aimed to compare differences in comorbidity proportions between surgical and nonsurgical approaches in Military Health System beneficiaries who had concurrent cruciate and meniscus injuries. The retrospective case control design included 36-month data that were analyzed to reflect 12 months prior to injury/surgery and 24 months after injury/surgery. A comparison of differences within and between groups in surgical and nonsurgical approaches was calculated and logistic regression was used to determine if surgery increased or decreased the odds of comorbidities at 24 months. In our sample of 2,438 individuals with concurrent meniscus and cruciate injury, 79.1% (n = 1,927) received surgical intervention and 20.9% (n = 511) elected for nonoperative management. All comorbidities demonstrated significant within-group differences from pre- to postsurgery for those with a surgical intervention; approximately, half the comorbidities increased (i.e., concussion or traumatic brain injury, insomnia, other sleep disorders, anxiety, posttraumatic stress disorder, and tobacco abuse disorder), whereas the other half decreased (i.e., chronic pain, apnea, cardiovascular disease, metabolic syndrome, mental health other, depression, and substance abuse disorders). The odds of acquiring a comorbid diagnosis after surgery reflected the bivariate comparisons with half increasing and half decreasing in odds. To our knowledge, this is the first study to explore comorbidity changes with a control group for individuals with concurrent meniscus and cruciate injuries.

show abstract

mentioning

confidence: 72%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Does Surgery for Concomitant Cruciate and Meniscus Injuries Increase or Decrease Subsequent Comorbidities at 2 Years?

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Lastly, our sample had a very low level of comorbidities, much lower than those reported in past military-based studies involving cruciate ligament and meniscus injury, low back pain, and hip surgery. [15][16][17][18] A majority of comorbidities were represented in <1% of the total population, with only substance abuse and tobacco abuse disorders reaching 2%. Low levels of comorbidities may be reflective of better overall health in our sample compared with previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…The study targeted patients who received care for a patella dislocation in the Military Health System. Consistent with previous studies, [15][16][17][18] we captured all patient care encounters 12 months before and 24 months after the initial diagnosis or surgery for every individual. The index date was the first date of diagnosis for a patellar dislocation.…”

Section: Participantsmentioning

confidence: 99%

Differences in Outcomes between Patellar Dislocations Managed in Emergent versus Non-Emergent Care Settings

et al. 2022

Self Cite

View full text Add to dashboard Cite

Patellar dislocations occur at a much higher rate in military than civilian populations. Past population-level studies have shown that surgical management is as good as or superior to conservative care and may reduce future reoccurrences. Although in acute cases and in civilian clinics, patellar dislocations are usually managed first in an emergent care setting, previous work suggests this can lead to increased costs. This study compared differences in downstream care type and intensity of services based on whether initial care occurred in emergent or non-emergent care settings. In our sample of 1,523 Military Health System (MHS) beneficiaries with patellar dislocation and 2-year follow-up, we found non-significant differences in costs, intensity of services, and rates of surgical repair regardless of whether the patient was initially seen in an emergent versus non-emergent care setting. Although we found significant increases in the use of imaging, patellar dislocation-related medical visits, and frequency of closed treatment approaches in emergent care settings, these values were very small and likely not clinically significant. These findings, which included all the patellar dislocations reported across the entire MHS in a 24-month period, suggest that neither emergent nor non-emergent care settings are likely to influence the long-term care received by the individual.

show abstract

Does Surgery for Cruciate Ligament and Meniscus Injury Increase the Risk of Comorbidities at 2 Years in the Military System?

Cited by 2 publications

References 47 publications

Does Surgery for Concomitant Cruciate and Meniscus Injuries Increase or Decrease Subsequent Comorbidities at 2 Years?

Does Surgery for Concomitant Cruciate and Meniscus Injuries Increase or Decrease Subsequent Comorbidities at 2 Years?

Differences in Outcomes between Patellar Dislocations Managed in Emergent versus Non-Emergent Care Settings

Contact Info

Product

Resources

About