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Socioeconomic Disparities and Procedural Complexity Influence Charges in Primary Patellar Instability Treatment: A
Timothy A Reiad1,2, Peter V Dinh1,2, David Bruni1,2
1Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, U.S.A.
Arthroscopy, Sports Medicine, and Rehabilitation
|September 22, 2025
Summary
Treatment costs for patellar instability vary significantly based on procedure, patient demographics, and hospital type. Tibial tubercle osteotomy is the most expensive, and disparities exist for non-White and Hispanic patients.
Area of Science:
- Orthopedic Surgery
- Health Economics
- Health Disparities
Background:
- Patellar instability requires surgical intervention, with varying costs.
- Understanding cost drivers is crucial for resource allocation and addressing disparities.
Purpose of the Study:
- Investigate factors influencing primary patellar instability treatment charges.
- Analyze the financial impact of concomitant procedures.
- Identify social determinants of health care charges.
Main Methods:
- Retrospective analysis of the 2019 Nationwide Ambulatory Surgery Sample.
- Included patients undergoing single stabilization procedures for patellar instability.
- Used generalized linear models to compare charges, adjusting for patient and hospital factors.
Main Results:
- Tibial tubercle osteotomy ($47,401) was the most expensive procedure, followed by medial patellofemoral ligament (MPFL) reconstruction ($41,333).
- Osteochondral grafting increased charges by $35,816.
- Non-White, Hispanic, and male patients faced higher charges. Private and urban hospitals also had higher costs.
Conclusions:
- Significant variability exists in patellar instability treatment charges.
- Procedural complexity, concomitant procedures, and demographic factors influence costs.
- Disparities in charges are linked to race, ethnicity, and hospital characteristics.
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