A study presented at the American Orthopaedic Society for Sports Medicine’s Specialty Day shines the spotlight on the factors that could contribute to a second anterior cruciate ligament (ACL) reconstruction procedure.
“Participation in physical therapy (PT) correlates with higher second ACL tear rate within both 12 & 24 months, especially in young females,” says lead researcher, Jonathan Godin, MD, MBA, of Duke University Medical Center in Durham, NC, in a media release from the American Orthopaedic Society for Sports Medicine.
“PT is of particular value in young athletes who are at a high risk of a future injury. However, our research noted that patients that heavily utilize PT after ACL reconstruction (more than 30 visits in a 6-month period) are in fact at the highest risk of a second ACL injury—as high as 25%.”
In the study using the PearlDiver database, Godin and his colleagues analyzed the records of 13,089 patients who had undergone ACL reconstruction between 2007 and 2014. The researchers analyzed demographic data, including age and sex, as well as the patient’s PT utilization, which was determined by the percentage of patients with postoperative physical therapy codes at 2, 4, 6, 12 and 24 weeks postsurgery.
Patients who had additional ACL reconstructions within 24 months were also identified. Nearly 90% of patients had at least one PT visit within 6 months of surgery. A total of 513 patients had a second ACL surgery. Women had a slightly higher rate of subsequent ACL surgery than men, 7.0% versus 6.0%, respectively, the release explains.
The scientists note that they don’t have an answer as to why a correlation exists between heavy utilization of physical therapy and the need for a secondary ACL procedure.
“Potential explanations include increased PT utilization in patients that return to high-risk sports, or potentially increased utilization in patients with poor neuromuscular skills that aren’t easily corrected in therapy,” Godin says.
“Regardless, this provides a simple strategy for identifying patients at the highest risk of subsequent injury for prevention research. We also hope to be able to investigate what the ‘sweet spot’ is for appropriate PT visits after ACL reconstruction, as increased utilization (and cost) don’t clearly correlate with improved outcomes,” Godin concludes.
[Source(s): American Orthopaedic Society for Sports Medicine, PRWeb]