The purpose of this study is to evaluate early outcomes with the use of a smartphone-based exercise and educational care management system after total hip arthroplasty (THA) and demonstrate decreased use of in-person physiotherapy (PT). A multicentre, prospective randomized controlled trial was conducted to evaluate a smartphone-based care platform for primary THA. Patients randomized to the control group (198) received the institution’s standard of care. Those randomized to the treatment group (167) were provided with a smartwatch and smartphone application. PT use, THA complications, readmissions, emergency department/urgent care visits, and physician office visits were evaluated. Outcome scores include the Hip disability and Osteoarthritis Outcome Score (HOOS, JR), health-related quality-of-life EuroQol five-dimension five-level score (EQ-5D-5L), single leg stance (SLS) test, and the Timed Up and Go (TUG) test.Aims
Methods
The purpose is to determine the non-inferiority of a smartphone-based exercise educational care management system after primary knee arthroplasty compared with a traditional in-person physiotherapy rehabilitation model. A multicentre prospective randomized controlled trial was conducted evaluating the use of a smartphone-based care management system for primary total knee arthroplasty (TKA) and partial knee arthroplasty (PKA). Patients in the control group (n = 244) received the respective institution’s standard of care with formal physiotherapy. The treatment group (n = 208) were provided a smartwatch and smartphone application. Early outcomes assessed included 90-day knee range of movement, EuroQoL five-dimension five-level score, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) score, 30-day single leg stance (SLS) time, Time up and Go (TUG) time, and need for manipulation under anaesthesia (MUA).Aims
Methods
The purpose of this study is to evaluate the early outcomes with the use of a smartphone-based exercise and educational platform after primary total hip arthroplasty 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 hip arthroplasty (THA). Patients randomized to the control group (198 patients) received the respective institution's standard of care. Those randomized to mymobility treatment group (167 patients) were provided an Apple Watch and mymobility smartphone application. The application provides pre and postoperative educational content, video directed exercise programs as well as tracks the patient's activity. Patients in the treatment group were not initially prescribed physical therapy, but could be if their surgeon deemed it necessary. Early outcomes assessed included 90-day hip range of motion, HOOS JR scores, 30-day single leg stance (SLS) and time up and go (TUG) test. We also evaluated PT utilization, THA complications associated with readmissions, ER visits not associated with readmissions, urgent care (non standard of care) visits, and physician office visits. Outcome scores include HOOS-Jr, EQ-5D-5L, single stance (SLS), Timed up and go (TUG). Satisfaction scores for the procedure and the mymobility study group were also recorded.Background
Methods
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
Patients with FNF may be treated by either total hip arthroplasty (THA) or hemiarthroplasty (HA). Utilizing American Joint Replacement Registry (AJRR) data, we aimed to evaluate outcomes in FNF treatment. Medicare patients with FNF treated with HA or THA reported to the AJRR database from 2012–2019 and CMS claims data from 2012–2017 were analyzed in this retrospective cohort study. “Early” was defined as less than 90 days from index procedure. A logistic regression model, including index arthroplasty, age, sex, stem fixation method, hospital size1, hospital teaching affiliation1, and Charlson comorbidity index (CCI), was utilized to determine associations between index procedure and revision rates.Introduction
Methods
Bundle payment models have clinical and economic impacts on providers. Despite efforts made to improve care, experience has shown that a few episodes with costs well above a target (bundle busters) can reduce or negate positive performances. The purpose of this study was to identify both the primary episode drivers of cost and patient factors that led to episodes above target. A retrospective study of 10,000 joint replacement episodes from a large healthcare system in CJR and a private orthopedic practice in BPCI was conducted. Episodes with costs greater than target price (TP) were designated as bundle busters and sub-divided into 4 groups:
< 1 standard deviation (SD) above TP (n=1700) > 1 to 2 SD above TP (n=240) > 2 to 3 SD above TP (n=70) > 3 SD above TP (n=70) Bundle busters were compared to the control that were at/below the TP (n= 7500). For the CJR/BPCI cohorts, one SD was defined as $10,700/$13,000, respectively. Two linear regressions assessed the likelihood of factors predicting a bundle buster and the total episode cost. These variables included demographics, acuity classifications, comorbidities, length of stay, readmissions, discharge disposition, post-acute utilization, and episode costs.Introduction
Methods
