Disruptions in standard care: anterior cruciate ligament reconstruction outcomes during the SARS-COV2 pandemic

ABSTRACT

Objective

The SARS-COV2 pandemic led to massive disruptions of care for orthopedic patients. Although many elective procedures were put on hold, a cohort of patients who underwent surgery prior to the outbreak of the pandemic were rendered unable to participate in standard post-operative care. The purpose of this study was to determine the methods of post-operative care in arthroscopic anterior cruciate ligament reconstruction patients who received care during an early height of the pandemic to those who received standard of care in the prior year. We aimed to correlate those results with 1-year clinical outcomes in the form of subjective surveys.

Methods

Retrospective chart review was used to identify patients who underwent primary anterior cruciate ligament reconstruction in February and March of 2020 (case) and 2019 (control) at a single institution. Workman’s compensation patients were excluded. Identified patients were asked to report post-operative care received, satisfaction with care, and complete the IKDC and Lysholm outcome measures. Surveys were conducted minimum 1-year post-operative.

Results

236 patients were identified, including 103 in 2020 and 133 in 2019. Follow-up data was collected for 73 patients (70.9%) in 2020 and 97 patients (72.9%) in 2019. Fifty-one COVID cohort patients (69.9%) had at least one clinical visit conducted via telehealth, compared to zero in the control. There were no differences in IKDC (82.8 ± 13.2 vs 85.0 ± 12.0, P = 0.29) and Lysholm (89.2 ± 11.3 vs 89.6 ± 10.8, P = 0.82) between groups. There were no differences in patient satisfaction with the care received (82.9 ± 22.4 vs 81.9 ± 21.8, P = 0.79)

Conclusion

Despite disruptions in care, anterior cruciate ligament reconstruction patients have excellent 1-year outcomes during the pandemic. Telehealth follow-up appointments may be appropriate for anterior cruciate ligament reconstruction patients beyond the pandemic and do not seem to adversely affect short-term patient reported outcome measures.

KEYWORDS:

• Anterior cruciate ligament reconstruction
• rehabilitation
• physiotherapy
• telehealth
• pandemic

Disclosure statement

In accordance with Taylor & Francis policy and my ethical obligation as a researcher, I am reporting that FP Tjoumakaris is a American Academy of Orthopaedic Surgeons Board or Committee Member, American Board of Orthopaedic Surgery Board or Committee Member, American Orthopaedic Society for Sports Medicine Board or Committee Member, Franklin/Keystone Biosciences LLC – Stockholder, Trice Medical Inc – Stockholder, Medical Device Business Services Inc – Paid consultant. I have disclosed those interests fully to Taylor & Francis.

No potential competing interest is reported by the remaining authors. (D Lee, AJ Lencer, BS Gibbs, RW Paul)

Additional information

Funding

No outside funding was received for any aspect of this work