12:15 PM

Return-to-play programs after ACL reconstruction are cost-effective for pediatric patients

Orthopedics Today reports on the findings of an HSS study led by pediatric orthopedic surgeon, Peter D. Fabricant, MD, MPH, which demonstrated a comprehensive return-to-play (RTP) program is cost-effective and reduces re-tear risk in young patients after anterior cruciate ligament (ACL) reconstructive surgery.

Dr. Fabricant and colleagues created a decision-analysis model to compare the standard ACL rehabilitation with a return-to-play RTP program, weighing the clinical and financial benefits. While the cost of an RTP program was approximately $1,721 more than the standard rehabilitation protocol, the risk of ACL graft rupture after completing the RTP program was reduced by 25 percent. Following a threshold analysis, it was determined that an RTP program is cost-effective, as long the additional cost of the RTP program was less than $2,092 or the risk of ACL graft rupture was reduced by more than 7.7 percent.

“In these – kind of – enhanced return-to-play [RTP] programs, there are typically additional physical therapy visits that are associated with it,” explained Dr. Fabricant. “There is additional testing in the form of motion analysis, strength testing, objective ligament testing – things that are not typically part of your standard physical therapy program.” He added, “In the end its cost saving for these insurance companies. So, they have to pay a little upfront, but they are covering less reoperation. So, they are actually saving money.”

Dr. Fabricant concluded, “I think as far as implications for future research. This can be an enduring tool to judge the cost-effectiveness of any given program - even a program generated in the future. We are starting to present this data to insurance companies and saying, ‘Look, this is a valuable thing that you should not only pay for your clients, but you should enthusiastically cover,’ because even though there is an upfront cost associated with it, that cost is recovered.”

Read the full article at Healio.com/news/orthopedics.