Improved Range of Motion and Decreased Complications After Total Knee Arthroplasty with Use of Plethy Recupe Remote Patient Monitoring: A Retrospective Study
Timothy Hui *
Plethy Inc., San Jose, CA, USA.
Hunter Greene
Summit Orthopedics, Carmichael, CA, USA.
Paul Sasaura
Summit Orthopedics, Carmichael, CA, USA.
Subu Subramanian
Plethy Inc., San Jose, CA, USA.
Bereket Ayalneh Sharew
Plethy Inc., San Jose, CA, USA.
Yordanos Woldebirhan
Plethy Inc., San Jose, CA, USA.
*Author to whom correspondence should be addressed.
Abstract
Background: Home exercise plans (HEP) are key to recovery from surgeries, but poor compliance limits benefits. Digital health shows promise in improving compliance. This retrospective study compared pain, range of motion (ROM), and manipulation under anesthesia (MUA) complications after a total knee arthroplasty (TKA) from one clinic where one group used digital health and another did not.
Methods: Patient population was all TKA patients from 9/1/21 to 4/30/22. For rehabilitation, 41 patients used Recupe, a digital app that instructs and monitors home exercises along with live coaching. 95 patients did not. Age, gender, and BMI between both groups were very similar.
Results: ROM improved significantly with the use of Recupe, improving to 120 degrees after 1 month – a key ROM for function. The non-Recupe group improved to 112 degrees in the same timeframe.
The need for MUA was significantly better for the Recupe group, where 2% required MUA versus 5% for the other group, indicating a lower risk of major complications.
Pain averaged 2.34/10 for the Recupe group after 1 month versus 2.86/10 for the non-Recupe group, though not statistically significant.
The Recupe group performed their exercises an average of 5.1 times per week.
Conclusions: The Recupe group and the Non-Recupe group both attended medical and physical therapy visits, so the significant differences in results are likely due to non-adherence of HEP by the Non-Recupe group. This suggests that lengthened musculoskeletal recovery amongst workers may be due to non-adherence to prescribed care plans, and that digital health may improve their compliance.
Use of Recupe during rehabilitation after a Total Knee Arthroplasty results in significantly faster ROM improvement and significantly decreased risk of Manipulation Under Anesthesia. Pain was also decreased though not to statistical significance.
Keywords: Digital health, total knee arthroplasty, home exercise, manipulation under anesthesia