HSS Study Finds Digital Implant and Wearable Technology Improves Recovery After Total Knee Replacement

Hospital for Special Surgery (HSS), the world's leading academic medical center focused on musculoskeletal health, today announced the results of a study evaluating the use of implanted digital devices combined with wearable devices, in patients who underwent total knee arthroplasty. The findings which were presented at the American Association of Hip and Knee Surgeons (AAHKS) annual meeting showed how valuable digital tools can be in a patient's recovery process.

The study, "Association of a Smart Implant-Enabled Digital Care Pathway with Complications and Healthcare Utilization Following Primary Total Knee Arthroplasty," compared postoperative healthcare utilization and total knee replacement complications between patients who used a digital care pathway and those who did not. The implantable and wearable devices allowed physicians to monitor patients remotely while enabling patients to track their own postoperative progress.

The treatment group included 1,080 patients; the control group was demographically similar and was made up of 43,200 patients. Patients were evaluated in several categories including stride distance and range of motion in their knee along with outcomes including opioid and rehab usage as part of the study, which ran from the fall of 2018 to the fall of 2023.

"The use of technology allowed us to intervene earlier, if necessary, rather than relying solely on scheduled visits," says William J. Long, MD, FRCSC, hip and knee replacement surgeon at HSS and the senior author of the study. "But it also gives patients the opportunity to evaluate how well they are doing. Tools like this are a way forward and provide real changes and improvements.

During the first 90 days post-surgery, patients who utilized the technology had lower incidence of opioid prescriptions filled (20% vs. 23%), used physical therapy less (37.3% vs. 43%) and had lower skilled nursing facility utilization (0.65% vs. 1.88%).

"These aren't just statistical improvements. These are significant, statistically relevant improvements because of these tools" says Dr. Long. "Essentially this is a starting point. This has the potential to reduce costs, improve outcomes and lower complication rates."

Similar results were seen one year postoperatively. Patients who were tracked digitally had lower rates of opioid prescriptions (24.5% vs 27.85%) and fewer periprosthetic joint infections (0.3% vs. 1%).

"Through a combination of monitoring and patient education, we observed lower infection rates and reduced use of nursing center facilities," Dr. Long stated. "Patients didn't need rehab because they were able to monitor their own progress. Digital tools can help patients stay engaged in their recovery while enabling clinicians to intervene more proactively when needed."