Web-Based Self-Directed Exercise Program Is Cost-Effective Compared to Formal Physical Therapy After Primary Total...

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Health Economics

Background:

• Web-based physical therapy (WBPT) offers a potential cost-reduction strategy for patients undergoing total knee arthroplasty (TKA).
• Existing research supports self-directed therapy post-TKA, but cost-effectiveness data are limited.
• This study investigates WBPT utilization, patient outcomes, and cost implications following TKA.

Purpose of the Study:

• To determine utilization trends of outpatient physical therapy (OPPT) versus WBPT after TKA.
• To assess patient outcomes based on the type of physical therapy utilized (WBPT, OPPT, or both).
• To evaluate the impact of WBPT usage on overall physical therapy costs post-TKA.

Main Methods:

• Retrospective review of 701 patients (731 TKAs).
• Patients received prescriptions for OPPT and access to a self-directed WBPT program.
• Functional scores, manipulation under anesthesia (MUA) rates, range of motion, and physical therapy costs were recorded preoperatively and 6 months postoperatively.

Main Results:

• 49.8% used WBPT, 34.7% used both WBPT and OPPT, and 23% used neither.
• Patients using both WBPT and OPPT had the lowest MUA rates.
• PT costs were 3.4x higher for patients undergoing MUA; increased WBPT use correlated with decreased costs and visits.

Conclusions:

• Web-based physical therapy (WBPT) is an effective strategy to mitigate outpatient physical therapy (OPPT) costs following total knee arthroplasty (TKA).
• WBPT can be integrated without compromising patient outcomes.
• Combined WBPT and OPPT approaches appear most beneficial for reducing adverse events like MUA.