DO SOCIOECONOMIC FACTORS INFLUENCE HOW WELL PATIENTS RECOVER FOLLOWING CARTILAGE REPAIR THERAPIES?

Salam Ismael, Tian Lan, Karina Wright, Mike Williams, Andrew Barnett, Peter Gallacher, Paul Jermin, Nilesh Makwana, Andrew Bing, Sally Roberts (retired), Charlotte Hulme, Helen McCarthy and Jan-Herman Kuiper

Two linked studies explored how a patient’s local area and living circumstances (socioeconomic background) might influence their recovery after different cartilage repair procedures. The socioeconomic status is calculated using government calculators related to a postcode, determined by an index of multiple deprivation (see picture insert). For repair of knee cartilage damage using the patients’ own cells (a procedure called autologous chondrocyte implantation (ACI)), patients from more deprived areas reported poorer functional outcomes one year after surgery, even after accounting for age, sex, BMI, smoking and baseline symptoms. This suggests that wider social and environmental factors may affect recovery, highlighting the need for additional support for these patients.

In contrast, for patients with cartilage damage in the ankle, treatment with a concentrate of the patients’ own bone marrow (called bone marrow aspirate concentrate (BMAC)) resulted in individuals from all socioeconomic backgrounds showing similar improvements at 12 months. Although individuals from more deprived areas arrived with worse symptoms, their recovery was comparable to those from less deprived areas.

Together, these findings show that socioeconomic deprivation can influence recovery after some cartilage repair procedures. These differences might be due to differences in recovery in the knee compared to the ankle or might be related to the specific therapy used (e.g. ACI or BMAC). This work underscores the importance of recognising social factors in treatment planning and ensuring targeted post-operative support where needed.