Is extended ambulatory physiotherapy (EAP) indicated after anterior cruciate ligament reconstruction? Comparison of the costs and benefits

Citation
Kh. Frosch et al., Is extended ambulatory physiotherapy (EAP) indicated after anterior cruciate ligament reconstruction? Comparison of the costs and benefits, UNFALLCHIRU, 104(6), 2001, pp. 513-518
Citations number
22
Language
TEDESCO
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
UNFALLCHIRURG
ISSN journal
0177-5537 → ACNP
Volume
104
Issue
6
Year of publication
2001
Pages
513 - 518
Database
ISI
SICI code
0177-5537(200106)104:6<513:IEAP(I>2.0.ZU;2-K
Abstract
Thirty-five patients were prospectively examined on average 5.9 and 11.1 mo nths after reconstruction of the anterior cruciate ligament. Eighteen patie nts were treated postoperatively with a regular physiotherapy (PT) program 2-3 times per week for 30 min, 17 patients with a special extended,and supe rvised rehabilitation program 3-5 times per week for 2.5 h. Criteria for ex clusion from this study were previous operation or fractures of the affecte d knee. The bases for the evaluation of the clinical results were the clini cal examination, the Lysholm and Tegner scores, KT 1000, angular reproducib ility according to Barrett (proprioception),and the figure-of-eight hop tes t. It appeared that patients treated with extended ambulatory physiotherapy (E AP) gained a significantly higher degree of functionality in the Lysholm sc ore after 5.9 months (p < 0.02) and the Tegner score after 11.1 months (p < 0.05) than patients treated with regular physiotherapy. Patients treated w ith EAP also displayed better results in the proprioceptive capability test with an angular deviation of 5.8 degrees after 5.9 months compared to 11 d egrees in patients receiving regular PT. After 11.1 months,there were no di fferences in proprioceptive capability between the two groups. Although the EAP patients were faster in the figure-of-eight hop test (0.39 s differenc e compared to 0.58 s in the PT patients), the results were not statisticall y significant. In KT 1000 ventral tibial instability was on average 21% low er in the PT patients than in the EAP patients. After 11.1 months, both gro ups exhibited the same median value of 3 mm. Furthermore, EAP patients were able to return to work after 36.7 days on av erage, a 35% shorter period than in the case of PT patients (55 days), also of statistical significance (p < 0.02). To conclude,the primarily higher c osts of this intensive rehabilitation program are justified by the better f unctional outcome linked with an earlier return to work.