Impact Of The Covid Pandemic On Acute Knee Injuries And Insurance Access To Health Care In High School Athletes

Abstract

Purpose: Several studies of professional sports showed increased incidence of injury following the COVID pandemic shutdowns. It is unclear if high school athletes were at similar risk of injury. Knee injuries are among the most common type of injury experienced by athletes. Due to their common nature and season-ending potential, it is important to understand the impact of COVID on these injuries. This study investigated the number of acute knee injuries as well as primary insurance of patients seen in a sports medicine clinic as a monthly trend before, during and after COVID in high school athletes. The purpose was to inform need for surgical resources for these injuries, and gauge access to healthcare during pandemic times. Methods: This was a retrospective observational study of patients aged 14-19 who visited a sports medicine clinic from 7/2017-6/2021 with an acute knee injury. 7/01/2017-2/2020 was defined as “Pre COVID”. 3/2020-7/2020 was defined as “During COVID”. Because many local sports resumed in Fall 2020, 8/2020-6/2021 was defined as “Post COVID”. All ICD10 codes including “ACL, MCL, LCL, PCL, meniscus” were included as acute knee injuries. T-tests were used to compare mean injuries per month in the “Pre COVID” timeframe to “During COVID” and “Post COVID”. A chi-square test was used to evaluate any difference in types of insurance in Pre, During, and Post-COVID. Results: 279 patients were identified who fit the criteria. Mean number of knee injuries evaluated in clinic per month during “Pre COVID” was 6.45 (SD = 3.4). In “During COVID”, the mean number of injuries was 1.6 (SD = 0.89), which was significantly lower than the “Pre COVID” (p = 0.004). In “Post COVID” the mean number of knee injuries returned to baseline at 6.45. There was no difference between the proportion of patients seen in clinic with commercial insurance vs government/Medicaid insurance during the Pre-COVID, During COVID, or Post-COVID time periods (p = 0.89). Conclusions: There was a statistically significant decrease in the number of acute knee injuries seen during the COVID pandemic. After high school sports resumed in August 2020, the number of acute knee injuries returned to the pre-COVID mean without increasing past pre-pandemic levels.