Date of Award

January 2021

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Jonathan N. Grauer

Abstract

Physical therapy (PT) is critical to successful outcomes after anterior cruciate ligament (ACL) reconstruction. The aim of the current study was to assess the number and temporal utilization of PT visits after ACL reconstruction in a national cohort. We hypothesize that PT visits will be concentrated early in the postoperative period. The PearlDiver (Colorado Springs, CO, USA) Humana insurance claims database was utilized. ACL reconstructions were identified by Current Procedural Terminology code. The mean, median, standard deviation, and range of number of PT visits for each patient were determined for the 52-weeks following ACL reconstruction. In total, 11,518 ACL reconstruction patients met inclusion criteria; the average ± standard deviation age was 32.62 ± 13.70 years old and 42.7% were female. Of these, 10,381 (90.1%) had PT post-operatively. On average, patients had 16.90 ± 10.60 PT visits (median: 16, interquartile range: 9 – 22 visits) after ACL reconstruction. Patients completed an average of 52% of their PT visits in the first six weeks, 75% in the first ten weeks, and 90% in the first sixteen weeks after surgery. Patients aged 10-19 had the highest number of PT visits (mean: 19.67 ± 12.09, median: 18, interquartile range: 12 – 25), significantly greater than other age groups (p < 0.001). Following ACL reconstruction, physical therapy is concentrated in the early post-operative period. Physicians, therapists, and patients may consider adjusting the limited access to physical therapy in order to optimize patient recovery.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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