Comparison of Traditional Physical Therapy to Internet-Based Physical Therapy after Knee Arthroscopy: A Prospective Randomized Controlled Trial Comparing Patient Outcomes and Satisfaction. Issue 7 (29th July 2019)

• Record Type: Journal Article
• Authors: Hadley, Christopher; McGrath, Mikayla; Prodoehl, John P.; Cohen, Steven B.; Emper, William D.; Hammoud, Sommer; Ciccotti, Michael G.; Freedman, Kevin B.; Brahmabhatt, Shyam; Mazur, Donald William
• Is Part Of: Orthopaedic journal of sports medicine. Volume 7:Issue 7(2019)Supplement 5
• Publication Date: 2019-07-29
• Subjects: Sports medicine -- Periodicals; Orthopedics -- Periodicals; Arthroscopy -- Periodicals; Arthroplasty -- Periodicals; Knee -- Surgery -- Periodicals; 616.7
• DOI: 10.1177/2325967119S00344
• Languages: English
• ISSNs: 2325-9671

Abstract

Objectives: Knee arthroscopy results in significant improvements in functional outcomes, pain and quality of life for patients suffering from meniscal tears. Traditionally, patients have undergone formal physical therapy (PT) after knee arthroscopy to regain function. Prior studies have demonstrated that patients who undergo internet-based PT after total knee arthroplasty performed as well as patients receiving traditional PT, but this has not been studied in the knee arthroscopy population. The goal of this study is to compare traditional outpatient physical therapy to internet-based physical therapy in patients undergoing knee arthroscopy for partial meniscectomy. Methods: Patients undergoing knee arthroscopy from October 2017 to September 2018 for partial meniscectomy were enrolled. Patients were randomized to either an outpatient or internet-based physical therapy program. Participants in the outpatient physical therapy were prescribed PT for 2 sessions per week for 4-6 weeks while participants in the online physical therapy group were instructed to login daily to track progress and complete their exercises a minimum of 3 times per week. Additionally, participants completed 4 questionnaires: VR-12 mental and physical health, International Knee Documentation Committee (IKDC), Modified Cincinnati Rating System (MCRS) and Lysholm pre-operatively, 1 week, 6 weeks and 6 months after surgery. The primary outcome of knee function was measured via the IKDC. Results: Of the 97 patients who met the inclusion criteria, 51 (52.6%) were in the internet-based physical therapy group and 46 (47.4%) were in the outpatient PT group. There were 57 males (58.8%) and 40 females (41.2%). Participants in the online physical therapy group logged into the platform an average of 2.74 times pre-operatively and 14.99 times post-operatively. Additionally, patients viewed their PT exercise videos, on average, 5.58 times pre-operatively and 36.71 times post-operatively. At final follow-up, there was no significant difference in the primary outcome with an average IKDC score for the online physical therapy (71.83) compared to outpatient PT group (74.23) [p = 0.699]. Additionally, there was no significant difference noted in the three secondary outcome measures between the internet-based physical therapy group and the outpatient PT group at final follow-up (Table 1). Furthermore, no significant difference was noted between the two patient cohorts pre-operatively and 1 week and 6 weeks after surgery in all four outcome measures (Table 1). Conclusion: The results of our study indicate that patients using internet-based PT had similar functional outcomes as patients using traditional outpatient PT following knee arthroscopy for partial meniscectomy. Table 1. Patient reported outcomes for the primary outcome (IKDC) measure and the secondary outcome measures (VR-12, MCRS Lysholm) Online Physical Therapy Group Outpatient Physical Therapy Group P-value Pre-op IKDC 44.88 42.92 0.499 VR-12 (PCS) 36.06 37.05 0.624 VR-12 (MCS) 54.26 54.75 0.826 MCRS 54.63 53.25 0.772 Lysholm 56.43 53.81 0.526 1 week Post-op IKDC 43.23 47.30 0.344 VR-12 (PCS) 39.52 40.24 0.838 VR-12 (MCS) 56.69 57.10 0.856 MCRS 59.37 60.77 0.749 Lysholm 62.92 58.38 0.389 6 weeks Post-op IKDC 57.09 61.67 0.397 VR-12 (PCS) 44.14 46.06 0.452 VR-12 (MCS) 56.45 54.79 0.575 MCRS 70.44 71.89 0.768 Lysholm 72.65 79.11 0.211 6 months Post-op IKDC 71.83 74.23 0.699 VR-12 (PCS) 49.94 49.53 0.897 VR-12 (MCS) 59.31 60.03 0.778 MCRS 84.08 83.86 0.972 Lysholm 83.33 89.00 0.346