The purpose of this study is to evaluate the early perioperative outcomes after primary knee arthroplasty with the use of a smartphone-based exercise and educational platform compared to a standard of care control group. A multicenter prospective randomized control trial was conducted evaluating the use of the mymobility smartphone-based care platform for primary total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA). Patients in the control group (224 patients) received the respective institution's standard of care typically with formal physical therapy. Those randomized to mymobility treatment group (192 patients) were provided an Apple Watch and mymobility smartphone application. The treatment group was not initially prescribed physical therapy, but could if their surgeon determined it necessary. Early outcomes assessed included 90-day knee range of motion, KOOS Jr scores, 30-day single leg stance (SLS) time, Time up and Go (TUG) time and need for manipulation under anesthesia (MUA). There was no significant difference in age, BMI or gender between groups.Background
Methods
A limited number of investigations with conflicting results have described perivascular lymphocytic infiltration (PVLI) in the setting of total knee arthroplasty. The purpose of this study was to determine if PVLI found in total knee replacements at the time of aseptic revision surgery was associated with worse clinical outcomes and survivorship. A retrospective review was conducted on 617 patients that underwent aseptic total knee arthroplasty revision who had histologic analysis for PVLI at the time of surgery. Clinical and radiographic data was obtained pre and postoperatively, 6 weeks post operatively, and then every year thereafter.Background
Methods
A smartphone-based care platform allows a customizable educational and exercise interface with patients, allowing many to recover after surgery without the need for formal physical therapy (PT). Furthermore, advances in wearable technology to monitor physical activity (PA) provides patients and physicians quantifiable metrics of the patient's recovery. The purpose of this study is to determine the feasibility of a smartphone-based exercise educational platform after primary knee arthroplasty as well as identifying factors that may predict the need for formal physical therapy. This study is part of a multi-institution, prospective study of patients after primary total knee arthroplasty (TKA) and partial knee arthroplasty (PKA) enrolled in a smartphone with smartwatch-based episode of care platform that recorded multimodal PA (steps, kcal, stairs). Postoperatively, all patients initially followed the smartphone-based exercise program. At the surgeon's discretion, patients were prescribed therapy if needed. The outcome of this study was the need for PT outside the app-based exercise program as well as time to return to preoperative step count. Variables assessed were preoperative weekly step counts (steps/day), weekly postoperative activity level (weekly step count compared to preoperative level), compliance with the exercise program (>75% completion) and patient demographic data including gender, age, BMI and narcotic use. One hundred eighty-eight patients were included in analysis: 45 PKA (24%) and 143 TKA (76%). Step count data was available on 135 patients and physical therapy data on 174.Introduction
Methods
Patients are often cautioned against a high level of activity following knee arthroplasty. The purpose of this study is to report on implant survivorship and outcomes of high activity patients compared to low activity patients after TKA. We identified 1611 patients (2038 knees) who underwent TKA with 5-year minimum follow-up. Patients were divided in two groups: Low activity (LA) (UCLA ≤5) and high activity (HA) (UCLA ≥ 6). Pre-and postoperative ROM, Knee Society scores, complications and reoperations were evaluated.Introduction
Methods
