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Correlation found between second ACL reconstruction and frequency of physical therapy utilization
SAN DIEGO — The number of physical therapy visits after ACL reconstruction correlated with the incidence of second reconstruction, according to research presented at the American Orthopaedic Society for Sports Medicine’s Specialty Day.
“We wanted to look into the influence of the number of [physical therapy] visits,” Jonathan Godin, MD, MBA, said in his presentation. “Only about 5% of patients utilized over 31 physical therapy visits. The vast majority were somewhere between one and 30. However, those who were heavy utilizers were driving the increase in second ACL rates at nearly eight-fold. [There] was no difference between patients utilizing one and thirty visits in terms of their second ACL reconstruction rates. Obviously, we do not fully understand why this is happening.”
Using the PearlDiver database, Godin and colleagues analyzed the records of about 13,000 patients who underwent ACL reconstruction between 2007 and 2014. Physical therapy utilization was determined by the presence of postoperative PT-related codes at 2 weeks, 4 weeks, 6 weeks, 12 weeks and 24 weeks after surgery. Patients who had a second ACL injury that required reconstruction within 2 years after the initial reconstruction were identified.
About 90% of patients had a minimum of one physical therapy visit in the 6 months after reconstruction. Second ACL reconstruction rates were 5% and 6.4% after 1 year and 2 years, respectively.
“Participation in physical therapy (PT) correlates with higher second ACL tear rate within both 12 [months] and 24 months, especially in young females,” Godin said in a press release.
More specifically, the researchers found patients who had between one and 30 physical therapy visits had a 2.3% rate of second ACL surgery. However, 31 or more physical therapy visits correlated with a greater risk of second ACL injury, with 16.5% of patients in this group requiring a second surgery.
“The next steps are to look at institutional data to do a true multivariable analysis to understand these drivers, and we believe that this is an exciting target, secondary prevention research opportunity moving forward,” Godin said in his presentation. – by Abbey Bigler
References:
Godin J, et al. Paper #22. Presented at: the American Orthopaedic Society for Sports Medicine Specialty Day at the American Association of Orthopaedic Surgeons Annual Meeting; March 18, 2017; San Diego.
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