Treatment Decision-Making for Anterior Cruciate Ligament Rupture From the Perspective of Physical Therapists in Australia: A Mixed Methods Study.
Stephanie R Filbay, Jane Rooney, Tammy Hoffmann and 4 others
PMID 40080635WHAT IT FOUND
Australian physical therapists had mixed beliefs about ACL rupture treatment.
Some saw surgery as best for young, active patients, while interviewees described surgeon opinion, referral order and patient expectations as barriers to offering rehabilitation first.
Key findings
0137% of physical therapists reported telling patients most of the time or always that surgery and rehabilitation alone result in similar outcomes on average, while 35% reported telling patients most of the time or always that surgery was best for returning to competitive sport.
02Surveyed physical therapists estimated that 21% of their patients with ACL rupture were managed with rehabilitation alone.
03When patients had already been recommended and booked for surgery, some physical therapists did not present non-surgical management as an option.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The survey relied on physical therapists' self-report, which may be affected by recall and social desirability. The survey was pilot tested but not evaluated for content validity, so it may not fully capture the intended topics. Not all consented participants completed every survey item, and missing data were analysed by item. Participants may not represent all Australian physical therapists who manage ACL rupture, because recruitment was voluntary and may have attracted those with a special interest. The response rate was unknown, and unique site visitors could not be counted, so someone may have completed the survey more than once. The qualitative analysis did not include member checking to confirm themes with participants.
Declared interests
Funding declarations name the Australian and New Zealand Musculoskeletal Clinical Trials Network, with the National Health and Medical Research Council listed as a seeding funder and investigator funder. The text states that funders had no role in the design, conduct or reporting of the study. No additional author conflicts are declared in the supplied text.
The easy way to misread this
Do not read this as evidence that rehabilitation alone is better or worse than surgery. The study describes physical therapists' beliefs, reported information and perceived barriers, not patient outcomes or a comparison of treatments.