Limited Use of Supervised Physical Rehabilitation Beyond 3 Months After Arthroscopic Anterior Cruciate Ligament Reconstruction With Greater Use in Female and Younger Patients.

Autor:	Rosenberg AM; Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A., Tiao J; Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A., Stern BZ; Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.; Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A., Hoang T; Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A., Zaidat B; Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A., Kantrowitz DE; Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A., Gladstone JN; Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A., Anthony SG; Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.. Electronic address: shawn.anthony@mountsinai.org.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2024 Nov 07. Date of Electronic Publication: 2024 Nov 07.
DOI:	10.1016/j.arthro.2024.10.041
Abstrakt:	Purpose: To characterize the initiation and use of supervised physical rehabilitation after arthroscopic anterior cruciate ligament reconstruction (ACLR), including overall duration of rehabilitation and number of rehabilitation visits, and to describe demographic and clinical predictors of rehabilitation initiation and use characteristics. Methods: Patients aged 14 to 64 years in the United States who underwent ACLR from 2017 to 2020 were identified using the Merative MarketScan Database. For patients initiating rehabilitation within 45 days postoperatively, the overall duration and number of visits within 1 year after surgery were determined. Visits were categorized into rehabilitation phases, with visits 0-90 days postoperatively categorized as phase I, 91-180 days as phase II, 181-270 days as phase III, and 271-365 days as phase IV. Multivariable regression models identified predictors of rehabilitation initiation, duration in days, and number of visits. Results: Of 20,097 patients who underwent ACLR, 88.1% (n = 17,704) initiated postoperative rehabilitation, receiving phase I services. Additionally, 55.0% (n = 11,053) received phase II services, 17.0% (n = 3417) phase III services, and 3.9% (n = 779) phase IV services. The median duration was 104 days (interquartile range 63-157), and the median number of visits was 21 (interquartile range 12-32). Multiple significant predictors of rehabilitation initiation, duration, and number of visits were found. Conclusions: Although most patients use supervised physical rehabilitation after ACLR, only 55% receive rehabilitation beyond 3 months and only 17% beyond 6 months after surgery. There are several significant drivers of rehabilitation initiation, overall duration, and number of visits. Female and younger patients have greater use of rehabilitation, and notable regional differences suggest an opportunity to improve standardization of care. Level of Evidence: Level III, retrospective descriptive study. Competing Interests: Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: This work was supported in part through the computational resources and staff expertise provided by Scientific Computing and Data at the Icahn School of Medicine at Mount Sinai and supported by the Clinical and Translational Science Awards (CTSA) grant UL1TR004419 from the National Center for Advancing Translational Sciences. S.G.A. reports a relationship with Smith & Nephew Inc that includes consulting or advisory; a relationship with Manhattan Surgery Center that includes equity or stocks; a relationship with Gotham Surgical Solutions & Devices that includes speaking and lecture fees and travel reimbursement; a relationship with Arthrex that includes: speaking and lecture fees and travel reimbursement; and a relationship with Miach Orthopedics that includes consulting or advisory. J.N.G. reports a relationship with DePuy Synthes and Medical Device Business Solutions that includes consulting or advisory and travel reimbursement; a relationship with Gotham Surgical Solutions & Devices that includes speaking and lecture fees and travel reimbursement; and a relationship with Medtronic that includes consulting or advisory. All other authors (A.M.R., J.T., B.Z.S., T.H., B.Z., D.E.K.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu