Surgeries (Aug 2024)

Severe Attrition and Poor Satisfaction in Patients Undergoing Telerehabilitation vs. Standard In-Person Rehabilitation after Arthroscopic Rotator Cuff Repairs and Anterior Cruciate Ligament Reconstructions

  • Kinjal D. Vasavada,
  • Dhruv S. Shankar,
  • Amanda Avila,
  • Edward S. Mojica,
  • Eoghan T. Hurley,
  • Kevin Lehane,
  • Scott D. Buzin,
  • Jacob F. Oeding,
  • Spencer M. Stein,
  • Guillem Gonzalez-Lomas,
  • Michael J. Alaia,
  • Eric J. Strauss,
  • Laith M. Jazrawi,
  • Kirk A. Campbell

DOI
https://doi.org/10.3390/surgeries5030050
Journal volume & issue
Vol. 5, no. 3
pp. 627 – 639

Abstract

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Background: The use of telerehabilitation after sports medicine procedures such as an arthroscopic rotator cuff repair (ARCR) and anterior cruciate ligament reconstruction (ACLR) has rapidly increased in recent years; however, the functional outcomes and patient satisfaction with telerehabilitation compared to in-person rehabilitation remain unclear. The purpose of this study was to compare the functional outcomes and patient satisfaction with telerehabilitation to in-person rehabilitation in a randomized controlled trial after two common sports procedures, ARCR and ACLR. Methods: Two randomized controlled trials were conducted involving patients scheduled to undergo ARCR or ACLR by one of six fellowship-trained sports medicine surgeons between October 2020 and November 2021. Each trial had an enrollment goal of 60 patients. Subjects were randomized 1:1 to receive telerehabilitation or in-person rehabilitation postoperatively. Functional outcome and satisfaction metrics were collected at baseline and at post-operative visits and compared between groups. Results: In total, 16 ACLR patients were enrolled, of whom 10 (62.5%) were assigned to in-person rehabilitation and 6 (37.5%) to telerehabilitation. Additionally, 32 ARCR patients were enrolled, of whom 20 (62.5%) were assigned in-person rehabilitation and 12 (37.5%) were assigned telerehabilitation. In total, of the 30 patients assigned to in-person rehabilitation, none reported a crossover to telerehabilitation. Of the 18 patients initially assigned to telerehabilitation, 12 (67%) completed the final follow-up survey, of which 11 (92%) reported a crossover; 9 patients completed in-person rehabilitation and 2 patients completed hybrid in-person and telerehabilitation. Conclusions: Patients preferred in-person rehabilitation compared to telerehabilitation after ACLR and ARCR, as evidenced by the nearly ubiquitous crossover from telerehabilitation to in-person rehabilitation in both studies. Our findings suggest that telerehabilitation protocols still need to be perfected, and that there may be a role for a hybrid in-person and tele-rehab model.

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