Reducing Disparities in Knee Arthroscopy for Adolescents

Hundreds of thousands of youth athletes require surgery for knee injuries annually. The incidence of operative knee injuries has skyrocketed, but surgery can be delayed due to late recognition and barriers, such as insurance, language, and difficulty navigating the healthcare system. Delays may have lifelong effects, including arthritis, persistent instability, poor patient reported outcomes, and reoperation. There is little patient-centered research on barriers to orthopaedic care, and none on interventions to reduce disparities in pediatric sports medicine. This study will focus on Hispanic children, a growing population nationally and 38% of the Chicago's children, who are at increased risk of delayed knee surgery and its sequelae compared to white, non-Hispanic patients. The overall objectives are to identify barriers to timely knee surgery in Hispanic athletes and develop an intervention to implement evidence on expedient treatment. The specific aims are to: (1) identify barriers and facilitators to timely care of knee injuries for Hispanic high school athletes; (2) design an evidence-based, culturally-tailored intervention for Hispanic athletes, families, and coaches to reduce delays in evaluation of acute knee injuries via user-centered principles; and (3) evaluate feasibility, acceptability, and appropriateness of the culturally-tailored intervention in a pilot study of Hispanic youth soccer leagues. The proposed aims will drive creation of a future community trial of a culturally-tailored intervention.