Great. Thanks for having me. I am not Donald Mazer, according to the books. So I'll be talking about the comparison of traditional PT to internet-based PT after nearthroscopes. Here are our disclosures. So by way of introduction, as we all know, partial meniscectomies are the most common orthopedic procedure, with north of half a million procedures performed annually in the U.S. Nearthroscopes can result in significant improvement in function, pain and quality of life for patients suffering from meniscal repairs, or TES. Traditionally, patients have undergone formal physical therapy anywhere from three to six weeks after surgery to really restore motion and function. However, as we all know, there is a significant cost to PT, whether that's to the patient or the system, and time associated with traditional outpatient physical therapy. There has been prior studies that have demonstrated the efficacy of internet-based physical therapy in the total knee and total hip population. However, to our knowledge, there has not been any studies in the knee arthroscope population. So the objective of this study was to compare patients undergoing a home internet-based PT program versus standard PT after a unilateral knee arthroscope for meniscal TES, and we were really looking at the functional outcomes, the patient satisfaction, and also cost associated. So patients undergoing the knee scopes of partial meniscectomies from October 2017 to December 2018 who consented were participated. They were consented two weeks before surgery, and if they already had a physical therapy plan, they were not included. Patients were randomized to either an outpatient or the internet-based PT program. They completed four questionnaires. We had the VR-12, the IKDC, the modified Cincinnati, the Lysholm, and all of these were collected preoperatively one week, six weeks, and six months after surgery. The primary outcome was measured by the IKDC. By way of demographics, we had 127 patients. We're actually at 165 at the moment, and the goal is around 200. As you can see, the average age is around 53, and we had slightly more males than females in this cohort. So our results at both the six-week and final six-month follow-up, there was no significant difference in the IKD scores between the two groups, and there's also no significant difference in the three secondary outcome measures between the PT group online and the outpatient physical therapy. There were no complications in either group, and there was no surge and reported crossovers either. One patient, however, from the outpatient PT group did end up getting converted to total knee arthroplasty four months after their surgery due to continued pain. In terms of some of the specific scores, as you can see across both groups, there was a positive trend from preoperative to the six months as expected, but no significant difference between the two, and that was consistent across the Lysholm, the modified Cincinnati, the VR-12 physical, and also the VR-12 mental. In terms of the PT summary, for patients that attended the outpatient physical therapy, the average number of PT visits was 11 visits, and just to note, I think the variation there of 1 to 26 is of interest. The same with the copays. It was patient-reported information here. It was $21 per copay, but as you can see, a huge variation between $0 and $100 with that copay. The satisfaction on the outpatient PT group was 7.67, and for the online PT group, it was 7.59, which had no statistical difference between the two. So the results of this study do indicate that inpatient internet-based physical therapy following a partial minisectomy does have equivalent outcomes to formal physical therapy. Additionally, I think these results have the potential for significant cost savings. In a world of us moving to bundles and value-based programs, we really need to be thinking about the variation that these post-acute services has. This obviously can also create better patient convenience and also access challenges that we do have at the moment. Further investigation is required into the internet-based physical therapy. I think the biggest challenge is actually to identify this patient preoperatively so that we can make an appropriate discharge plan for these patients. Thank you.

internet-based PT

knee arthroscopy

functional outcomes

patient satisfaction

cost savings