Improved Range of Motion and Decreased Complications After Total Knee Arthroplasty with Use of Plethy Recupe Remote Patient Monitoring – A Retrospective Study

Abstract

Background Home exercise plans are key to recovery from surgeries, but poor compliance limits the benefit. Though non-compliance can be up to 70% from previous research, digital health shows promise in improving compliance. This retrospective study compared pain, range of motion (ROM), and manipulation under anesthesia (MUA) complications after a total knee arthroplasty (TKA) from a clinic where one group used digital health and another did not. There is little previous research on this topic, so this study could show the benefits of digital health on joint replacement rehabilitation. Methods Patients were retrospectively selected from Summit Orthopedics TKA patients from 9/1/21 to 4/30/22. 41 patients used Recupe, a digital app that instructs and monitors home exercises along with live coaching with their TKA rehabillitation. 95 patients did not. Age, sex, and BMI between both groups were very similar. Results ROM improved significantly with the use of Recupe, improving to 120 degrees after 1 month - a key ROM level for functional use as indicated by studies. The non-recupe group improved to 112 degrees in the same timeframe. The need for MUA was significantly better for the Recupe group, where 2% required MUA versus 5% for the other group, indicating a lower risk of major complications. Pain averaged 2.34/10 for the Recupe group after 1 month versus 2.86/10 for the non-recupe group, though the decrease did not reach statistical significance. The Recupe group performed their exercises an average of 5.1 times per week. Conclusions The Recupe group and the Non-Recupe group both attended medical and physical therapy visits, so the significant differences in results are likely due to non-adherence of HEP by the Non-Recupe group. These results suggest that lengthened musculoskeletal recovery amongst workers may be due to non-adherence to their prescribed care plan, and that digital health may be an excellent way to improve their compliance. Clinical Significance Use of Recupe during rehabilitation after a Total Knee Arthroplasty results in significantly faster ROM improvement and significantly decreased risk of Manipulation Under Anesthesia. Pain was also decreased though not to statistical significance.