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Web-Based Self-Directed Exercise Program Is Cost-Effective Compared to Formal Physical Therapy After Primary Total Knee Arthroplasty.
Zachwieja, Erik; Theosmy, Edwin G; Yacovelli, Steven J; Beatty, Evan W; McGrath, Mikayla E; Lonner, Jess H.
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  • Zachwieja E; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Theosmy EG; Department of Orthopaedic Surgery, Rowan University School of Osteopathic Medicine, Stratford, NJ.
  • Yacovelli SJ; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Beatty EW; Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, PA.
  • McGrath ME; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
  • Lonner JH; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
J Arthroplasty ; 35(9): 2335-2341, 2020 09.
Article en En | MEDLINE | ID: mdl-32423757
BACKGROUND: Web-based physical therapy (WBPT) is a potential means to reduce costs following total knee arthroplasty (TKA). Although outcomes data support the use of self-directed therapy after TKA, there is a paucity of literature evaluating its cost-effectiveness. This study aimed to determine utilization trends of either outpatient physical therapy (OPPT) or WBPT after TKA, assess the outcomes of patients based on their use of WBPT, OPPT, or both, and evaluate OPPT costs based on the amount of WBPT used. METHODS: A retrospective review of 701 patients (731 TKAs) was performed. Patients were given a prescription for OPPT and access to a self-directed WBPT program. Functional scores were obtained preoperatively and 6 months postoperatively, and the rate of manipulation under anesthesia (MUA), range of motion, and PT costs were recorded. RESULTS: About 49.8% of patients utilized WBPT, 34.7% of patients utilized WBPT and OPPT, and 23% of patients utilized neither source of therapy. Patients that utilized both WBPT and OPPT demonstrated the lowest rates of MUA. There were no differences in postoperative outcomes based on the number of WBPT logins. Overall, PT cost was 3.4× higher for those that underwent MUA. Subgroup analysis of patients that utilized WBPT revealed that the cost and number of PT visits decreased as the number of logins increased. Patients younger than 65 utilized more WBPT and OPPT while demonstrating worse outcomes (lower Knee Injury and Osteoarthritis Outcome Score for Joint Replacement postoperative scores and more MUAs). CONCLUSION: WBPT can be an effective option to offset costs associated with OPPT, without compromising outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Osteoartritis de la Rodilla Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Osteoartritis de la Rodilla Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos