Surface sensor technology provides useful information about the status of an individual's health and been available for many years, but has not been widely adopted by orthopaedic surgeons. However, its usage may be become more prominent as COVID-19 has created a shift towards telemedicine. This study reports the use of a joint specific surface sensor to remotely monitor the recovery of patients who underwent knee replacement surgery prior to the enforced stay-at-home social distancing necessitated by the COVID-19 pandemic. The study group consisted of 29 patients who underwent primary, unilateral total knee arthroplasty (TKA). A knee joint specific surface sensor (TracPatch™) was placed following surgery and kept on patients for 3 weeks postoperatively. The patients’ range of motion (ROM), exercise compliance, distance walked, pain, skin temperature, and incision appearance were monitored and transmitted electronically to health care providers. Patients were grouped by gender, age and BMI for analysis of functional outcome measurements.Introduction
Methods
Total Knee Arthroplasty (TKA) provides patients with significant improvements in quality of life. Subjective patient reported outcome measures (PROMs) are traditionally used to measure preoperative functional status and postoperative outcomes. However, there are limitations to PROMs. In particular, they provide virtually no functional information in the first 3 weeks after surgery, which could be used to guide the patient's recovery. Newly available wearable electronic sensors make it possible to: 1) measure important functional outcomes following TKA; 2) guide the patient's physical therapy (PT); and 3) provide real-time functional and clinical information to the provider. Compliance with PT after TKA is a challenge. Patients cite time, transportation, and cost as deterrents to PT appointments. However, an intensive PT program is essential in TKA. Surface sensor devices may be able to increase PT compliance by guiding patients through exercises at home. Additionally, these devices can transmit PT progress in real-time to the providers, allowing them to monitor and assist the patient's recovery. Our study investigates the feasibility of using a surface sensor device (TracPatch™) on patients following TKA. We sought to answer the following questions: 1) Will patients tolerate the device; 2) Will patients comply with device instructions; 3) Will patients be able to use the smart phone application; 4) Will the device collect, transmit, and store data as it was designed? We believe these fundamental questions must be answered as we enter the era of personal sensor-measured functional outcomes. 20 patients undergoing primary, unilateral TKA were enrolled in this IRB approved study. At the pre-surgical visit, patients were given instructions for the device and smart phone application. Each patient used the device in the week prior to surgery, and data was collected. The device was again applied in the operating room. For 3 weeks post-operatively, the device collected functional data, along with WOMAC, OKS, KSS, PROMIS, and VAS pain scores. A satisfaction survey was collected on the device.Background
Methods
Tissue engineering strategies to heal critical-size bone defects through direct bone formation are limited by incomplete integration of grafts with host bone and incomplete vascularisation. An alternative strategy is the use of cartilage grafts that undergo endochondral ossification. Endochondral cartilages stimulate angiogenesis and are remodeled into bone, but are naturally found in only small quantities. We sought to develop engineered endochondral cartilage grafts using human osteoarthritic (OA) articular chondrocytes. Study approval was obtained from our human and animal ethics review committees. Human OA cartilage was obtained from discarded tissues from total knee replacements. Scaffold-free engineered grafts were generated by pelleting primary or passaged chondrocytes, followed by culture with transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein 4. Samples were transplanted into immunocompromised mice either subcutaneously or into critical-size tibial defects. Grafts derived from passaged chondrocytes from either of two patients (64 year old and 68 year old men) where implanted into tibial defects in five mice. Bone formation was assessed with histology after four weeks of implantation.Background
Methods
