Marc Darrow, MD,JD.

A June 2022 study (1) look at patient reaction to mandatory physical therapy requirements in patients waiting for a joint replacement. As noted in this study: “(Insurance) coverage policies have recently begun requiring physical therapy prior to total hip arthroplasty and total knee arthroplasty. It remains controversial if such a mandate is appropriate for patients with end-stage, symptomatic osteoarthritis. The purpose of this study is to assess if such patients are amenable to delaying surgery for a trial of physical therapy.”

  • Two hundred patients were successfully contacted and agreed to participate. The average age was 66 years, 47% were male, the mean body mass index put these patients into the obese range. Of the 200 patients, 66% were scheduled for total knee arthroplasty.
  • In total, 157 patients (79%) stated they had not done physical therapy in the preceding 6 months, and 185 patients (93%) stated they would not want to delay surgery for mandatory physical therapy. The most common reasons for refusing physical therapy were “surgery is inevitable” (44%) and “unlikely to improve pain” (29%).

1 Grace TR, Eralp I, Khan IA, Goh GS, Siqueira MB, Austin MS. Are Patients With End-Stage Arthritis Willing to Delay Arthroplasty for Payer-Mandated Physical Therapy?. The Journal of Arthroplasty. 2022 Jun 1;37(6):S27-31.

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