Smartphone-based care platform may reduce health care resource use after knee arthroplasty
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GRAPEVINE, Texas — Use of a smartphone-based care platform after partial or total knee arthroplasty had similar 1-year clinical outcomes as standard of care and less health care resource utilization.
David A. Crawford, MD, and colleagues randomly assigned patients undergoing either partial or TKA to undergo either a smartphone-based care management program (n=160; mymobiliy, Zimmer Biomet) or standard of care (n=241) postoperatively.
“The outcomes we evaluated were both the health care resource utilizations, such as physical therapy, readmissions, ED or urgent care visits [and] nonstandard-of-care office visits, with clinical outcomes being manipulation under anesthesia, [Knee Injury and Osteoarthritis Outcome Score for Joint Replacement] KOOS JR, [EuroQol-5D] EQ-5D and return to activities at 3 months,” Crawford said in his presentation at the American Association of Hip and Knee Surgeons Annual Meeting.
When looking at the partial knee and TKA cohorts combined, Crawford noted patients in the treatment group used significantly less physical therapy and had a significantly lower incidence of ED visits within the first year. Results showed both groups had similar KOOS JR and EQ-5D scores at 1-year follow-up.
At 6-month follow-up, patients who had crossed over to the control group had significantly lower KOOS JR scores, according to Crawford.
“At 1 year, patients who did well with the app and did not crossover did better than the control group,” Crawford said.
Overall, Crawford noted 65% of patients who underwent TKA and 46% of patients who underwent partial knee arthroplasty utilized physical therapy postoperatively compared with 94.8% and 94% of patients in the control groups, respectively.
“Then, lastly, return to activities. This was both what percentage of patients returned to activities by 3 months and the number of days it took them to get there,” Crawford said. “The only significant finding was, in the treatment group, it took less days to encourage walking without an assisted device. Nothing else was significantly different.”
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Crawford DA, et al. Paper 30. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 3-6, 2022; Grapevine, Texas.
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