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

Area of Science:

• Orthopedics
• Military Health
• Health Services Research

Background:

• Patellar dislocations are more prevalent in military populations.
• Surgical management may offer advantages over conservative care for patellar dislocations.
• Initial emergent care for patellar dislocations may increase healthcare costs.

Purpose of the Study:

• To compare downstream care type and intensity of services for patellar dislocations based on initial care setting (emergent vs. non-emergent).

Main Methods:

• Retrospective analysis of 1,523 Military Health System beneficiaries with patellar dislocation.
• 2-year follow-up period to assess downstream care.
• Comparison of costs, service intensity, and treatment approaches between emergent and non-emergent initial care settings.

Main Results:

• No significant differences in overall costs, service intensity, or surgical repair rates were found between emergent and non-emergent initial care settings.
• Slight, likely clinically insignificant, increases in imaging, medical visits, and closed treatments were observed in the emergent care group.
• Findings encompass all patellar dislocations within the Military Health System over 24 months.

Conclusions:

• The initial care setting (emergent vs. non-emergent) for patellar dislocations does not appear to influence long-term patient outcomes or healthcare utilization.
• Healthcare providers can consider non-emergent settings for initial patellar dislocation management without anticipated negative downstream effects.