Differences in the Course of Rehabilitation and Outcomes for Publicly Insured Pediatric Patients After Anterior Cruciate Ligament Reconstruction

Background: Previous research has demonstrated individuals with public insurance may encounter delays accessing care and experience different orthopedic management for musculoskeletal injuries. Rehabilitation after anterior cruciate ligament reconstruction (ACLR) is critical to optimize outcomes. Th...

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Bibliographic Details
Published in:Orthopaedic journal of sports medicine 2022-05, Vol.10 (5_suppl2)
Main Authors: Greenberg, Elliot, Butler, Lauren, Giampetruzzi, Nicholas, Link, Meredith, Prati, Victor, Weaver, Adam, Saper, Michael
Format: Article
Language:English
Subjects:
Knee
Orthopedics
Patients
Pediatrics
Rehabilitation
Sports medicine
Surgery
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Summary:Background: Previous research has demonstrated individuals with public insurance may encounter delays accessing care and experience different orthopedic management for musculoskeletal injuries. Rehabilitation after anterior cruciate ligament reconstruction (ACLR) is critical to optimize outcomes. The effect of insurance status on rehabilitation practice and patient outcomes among youth athletes has not been explored. Purpose: To examine the effect of insurance type (public vs private) on physical therapy (PT) visit utilization and outcomes within pediatric and adolescent patients after ACLR. Methods: This was a sub-analysis of a larger retrospective dataset of patients who underwent primary ACLR between 2013 and 2019 at 5 institutions. All patients followed a structured rehabilitation protocol as directed by the treating institution and completed a battery of return to sport (RTS) tests which included single-legged hop testing. PT visit frequency was assessed both overall and by time period (first 6 weeks, week 7-month 3, 3-6 months, and 6+ months). PT visits were recorded up until the time of last recorded hop test within 12 months post-surgery. The average number of visits attended per week during the observed time was calculated for each patient. The effect of insurance status on PT management was analyzed using T-tests. The effect of insurance status on the odds of passing hop tests was assessed using multivariable logistic regression with a random effect of site. Adjusted models controlled for time to test in months. An alpha level of p
ISSN:2325-9671
2325-9671
DOI:10.1177/2325967121S00388