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Differences in Outcomes between Patellar Dislocations Managed in Emergent versus Non-Emergent Care Settings
Journal of Knee Surgery ( IF 1.6 ) Pub Date : 2022-07-12 , DOI: 10.1055/s-0042-1749079
Chad E Cook 1, 2, 3 , Mohammad Saad 1 , Christopher J Tucker 4, 5 , Kyong S Min 6 , Richard B Westrick 7 , Daniel I Rhon 6, 7
Affiliation  

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.



中文翻译:

在急诊与非急诊护理环境中管理的髌骨脱位的结果差异

髌骨脱位在军队中的发生率远高于平民。过去的人群研究表明,手术治疗与保守治疗一样好或优于保守治疗,并且可以减少未来的复发。尽管在急性病例和民用诊所中,髌骨脱位通常首先在紧急护理环境中进行处理,但之前的工作表明这可能会导致成本增加。本研究根据初始护理发生在紧急或非紧急护理环境中比较下游护理类型和服务强度的差异。在我们的 1,523 名患有髌骨脱位的军事卫生系统 (MHS) 受益人样本中,我们发现在成本、服务强度、和手术修复率,无论患者最初是在急诊还是非急诊护理环境中看到。尽管我们发现影像学的使用、髌骨脱位相关的就诊以及急诊护理环境中封闭治疗方法的频率显着增加,但这些值非常小,可能没有临床意义。这些发现包括 24 个月内整个 MHS 报告的所有髌骨脱位,表明紧急或非紧急护理环境都不太可能影响个人接受的长期护理。这些值非常小,可能没有临床意义。这些发现包括 24 个月内整个 MHS 报告的所有髌骨脱位,表明紧急或非紧急护理环境都不太可能影响个人接受的长期护理。这些值非常小,可能没有临床意义。这些发现包括 24 个月内整个 MHS 报告的所有髌骨脱位,表明紧急或非紧急护理环境都不太可能影响个人接受的长期护理。

更新日期:2022-07-13
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