O2062: Is Preferred Language Other Than English Associated with Delayed Surgery Following Anterior Cruciate Ligament Injury in Children and Adolescents?

Background: Previous studies have investigated the negative impact of delayed care and meniscal pathology in the setting of anterior cruciate ligament reconstruction (ACLR). However, the impact of the patient or family’s preferred language on clinical care is unclear. The purpose of this study is to identify differences in surgical timing and meniscal pathology along the lines of preferred language.

Methods: Patients aged 18 years or less that underwent primary ACL reconstruction (ACLR) at a single tertiary children’s hospital were reviewed for this retrospective cohort study. We included 543 patients whose mean age was 15.8 ± 1.8 years and 50.8% were male. The family’s preferred language was noted, as were demographic data, time between injury and surgery, and intra-operative findings. One hundred thirteen patients’ families (20.8%) preferred a language other than English. Univariate analysis included independent samples t-tests, Mann-Whitney U-tests, and Fisher exact tests, as appropriate. Purposeful entry multivariate regression analyses were used to determine whether PLOE was predictive of increased time to surgery, concomitant meniscus injury, or need for meniscectomy while adjusting for confounding variables.

Results: The median time between injury and surgery was 68.7 days [interquartile range (IQR) 79.5] for patients whose families preferred English and 103.2 days (IQR 107.4) for those with a PLOE (p < 0.001). In univariate analysis, PLOE was associated with ACLR greater than 60, 90, and 180 days after injury. It was also associated with increased frequency of concomitant meniscus tears and partial meniscectomy. When adjusting for insurance status and other variables in multivariate analysis, patients whose families had a PLOE were at 2.2 times higher odds (95% CI 1.3 to 3.8; p=0.005) of undergoing surgery >60 days after injury and 1.8 times higher odds (95% CI 1.1 to 2.8; p=0.02) of ACLR >90 days after injury. PLOE was not predictive of surgical delay beyond 180 days, concomitant meniscal pathology, or need for meniscectomy in multivariate analysis.

Conclusion: In this study of children and adolescents undergoing primary ACLR, patients whose families prefer a language other than English experienced longer delay between injury and ACLR. Even when accounting for insurance status and other variables, PLOE was predictive of surgery later than 60 and 90 days after injury.