PMID- 36252744
OWN - NLM
STAT- MEDLINE
DCOM- 20230214
LR  - 20230216
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 38
IP  - 3
DP  - 2023 Mar
TI  - A Home-Based, Remote-Clinician-Controlled, Physical Therapy Device Leads to 
      Superior Outcomes When Compared to Standard Physical Therapy for Rehabilitation 
      After Total Knee Arthroplasty.
PG  - 497-501
LID - S0883-5403(22)00929-9 [pii]
LID - 10.1016/j.arth.2022.10.009 [doi]
AB  - BACKGROUND: The optimal postoperative rehabilitation regimen following total knee 
      arthroplasty (TKA) is not clearly defined. The advent of telerehabilitation 
      offers potential for increased patient convenience and decreased cost, while 
      maintaining similar outcomes to traditional physical therapy (PT). Therefore, we 
      evaluated a novel, home-based, clinician-controlled, multi-modal evaluation and 
      therapy device with telerehabilitation functionality for TKA. METHODS: A total of 
      135 consecutive TKA patients receiving standard therapy protocol (STP) were 
      compared to 135 consecutive patients receiving a home-based clinician-controlled 
      therapy system (HCTS). Outcomes were assessed at 2, 6, and 12 weeks, including 
      visual analog scale (VAS) for pain, knee injury and osteoarthritis outcome score 
      JR (KOOS JR), and knee range of motion (ROM) measured by the same certified 
      physical therapists. RESULTS: Postoperative knee ROM was greater in the HCTS 
      group at all time points throughout the study period (P < .001 at 2, 6, and 12 
      weeks). VAS and the KOOS JR functional scores were statistically better (P < 
      .001) in the HCTS group at all time points and exceeded the threshold for minimal 
      clinically important difference (MCID) for both VAS and KOOS JR. There were 
      significantly fewer cases of arthrofibrosis requiring manipulation under 
      anesthesia (MUA) in the HCTS group (1.48 versus 4.44%). CONCLUSION: Following 
      TKA, a novel, home-based, clinician-controlled, multi-modal therapy device was 
      superior to standard PTduring the first 12 weeks postoperatively for ROM, KOOS 
      JR, and VAS (with all scores exceeding the MCID) and had substantially fewer 
      manipulations for arthrofibrosis.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Summers, Spencer H
AU  - Summers SH
AD  - Hospital for Special Surgery Florida, West Palm Beach, Florida.
FAU - Nunley, Ryan M
AU  - Nunley RM
AD  - Department of Orthopaedics, Washington University, Saint Louis, Missouri.
FAU - Slotkin, Eric M
AU  - Slotkin EM
AD  - Orthopaedic Associates of Reading, Reading, Pennsylvania.
LA  - eng
PT  - Journal Article
DEP - 20221015
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Knee/adverse effects
MH  - Physical Therapy Modalities
MH  - Knee Joint/surgery
MH  - *Joint Diseases/surgery
MH  - Range of Motion, Articular
MH  - Treatment Outcome
MH  - *Osteoarthritis, Knee
OTO - NOTNLM
OT  - TKA
OT  - arthroplasty
OT  - knee
OT  - recovery
OT  - rehabilitation
OT  - telemedicine
EDAT- 2022/10/18 06:00
MHDA- 2023/02/15 06:00
CRDT- 2022/10/17 19:25
PHST- 2022/05/23 00:00 [received]
PHST- 2022/10/03 00:00 [revised]
PHST- 2022/10/10 00:00 [accepted]
PHST- 2022/10/18 06:00 [pubmed]
PHST- 2023/02/15 06:00 [medline]
PHST- 2022/10/17 19:25 [entrez]
AID - S0883-5403(22)00929-9 [pii]
AID - 10.1016/j.arth.2022.10.009 [doi]
PST - ppublish
SO  - J Arthroplasty. 2023 Mar;38(3):497-501. doi: 10.1016/j.arth.2022.10.009. Epub 
      2022 Oct 15.