A Home-Based, Remote-Clinician-Controlled, Physical Therapy Device Leads to Superior Outcomes When Compared to Standard Physical Therapy for Rehabilitation after Total Knee Arthroplasty

J Arthroplasty. 2022 Oct 14:S0883-5403(22)00929-9. doi: 10.1016/j.arth.2022.10.009. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal postoperative rehabilitation regimen following total knee arthroplasty (TKA) is not clearly defined. The advent of telerehabilitation offers potential for increased patient convenience and decreased cost, while maintaining similar outcomes to traditional physical therapy. Therefore, we evaluated a novel, home-based, clinician-controlled, multi-modal evaluation and therapy device with telerehabilitation functionality for TKA.

METHODS: A total of 135 consecutive TKA patients receiving standard therapy protocol (STP) were compared to 135 consecutive patients receiving a home-based clinician-controlled therapy system (HCTS). Outcomes were assessed at 2, 6, and 12 weeks, including visual analog scale. (VAS) for pain, Knee injury and Osteoarthritis Outcome Score JR (KOOS JR), and knee range of motion (ROM) measured by the same certified physical therapists.

RESULTS: Postoperative knee ROM was greater in the HCTS group at all time points throughout the study period (p<.001 at 2, 6 and 12 weeks). VAS and the KOOS JR functional scores were statistically better (p<0.001) in the HCTS group at all time points and exceeded the threshold for Minimal Clinically Important Difference (MCID) for both VAS and KOOS JR. There were significantly fewer cases of arthrofibrosis requiring manipulation under anesthesia in the HCTS group (1.48 vs. 4.44%).

CONCLUSIONS: Following TKA, a novel, home-based, clinician-controlled, multi-modal therapy device was superior to standard physical therapy during the first 12 weeks postoperatively for ROM, KOOS JR, and VAS (with all scores exceeding the Minimal Clinically Important differences), and had substantially fewer manipulations for arthrofibrosis.

PMID:36252744 | DOI:10.1016/j.arth.2022.10.009