Patient Satisfaction and Outcomes Utilizing a Portable Medical Device with Adaptive Telemedicine Technology for Rehabilitation Following Total Knee Arthroplasty.

Abstract

Introduction: A portable medical rehabilitation device with adaptive telemedicine technology provides an adjunct therapy following total knee arthroplasty (TKA). The physician-monitored internet-based interface allows for physician-directed or free use of the portable medical rehabilitation device by the patient. The purpose of this study was to characterize patients' satisfaction with its use, as well as its impact on perioperative range of motion (ROM).

Materials and methods: After institutional review board (IRB) approval, patients who used the portable rehab device postoperatively completed a 12-question survey that assessed use and satisfaction metrics at their six-week postoperative visit. Range of motion (ROM) at their six-week postoperative visit was analyzed against their survey responses. A total of 101 patients (42 men, 58 women, one preferred not to answer; 101 knees) were available for analysis, with a mean patient age of 68 years (range 48-84 years).

Results: Overall satisfaction was 93%, with 14.9% noted "helpful," 45.5% "strongly helpful," and 32.7% "very strongly helpful." Insurance covered the cost in 72%, while 23% paid for their device out of pocket with minimal impact, and 5% felt the out-of-pocket cost to be not worthy of the benefit. Nearly all (96%) of the patients stated they would recommend the device. Patients reported using their portable medical rehabilitation device for approximately two to three weeks (39.6%), two to three times per day (65.3%), and 11 to 15 minutes per session (69.3%). Older patients had lower usage than younger patients (p<0.001), and men trended toward higher usage than women (p=0.055). Mean six-week postoperative knee ROM was a 0-111° arc of motion. Change in ROM was not found to correlate with duration of use (p=0.385).

Conclusion: The portable medical device is an option for rehabilitation after TKA with high patient satisfaction and low-cost burden, while achieving an appropriate arc of motion by six weeks following TKA. Further comparative investigations will be needed to determine the optimal duration of use following TKA.