Abstract
IntroductionNew app-based programs for postoperative rehabilitation have been developed, but no long-term study has been published to date. Thus, a prospective randomized control trial with 2-year follow-up was performed to evaluate the effectiveness of app-based rehabilitation (GenuSport) compared to a control group after total knee arthroplasty (TKA).MethodsBetween April and October 2016, 60 patients were enrolled in the study. Twenty-five patients were lost to follow-up, leaving 35 patients undergoing TKA for inclusion. In this group, twenty patients received app-based exercise program and 15 were randomized to the control group. The mean age was 64.37 ± 9.32 years with a mean follow-up of 23.51 ± 1.63 months. Patients in the app group underwent an app-based knee training starting on the day of surgery; whereas, patients in the control group underwent regular physiotherapy. Functional outcome scores using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS) and VAS of pain were analyzed.ResultsIn the short term, significant differences between the app group and control group in time of 10-m walk (19.66 ± 7.80 vs. 27.08 ± 15.46 s; p = 0.029), VAS pain at rest and activity (2.65 ± 0.82 vs. 3.57 ± 1.58, respectively 4.03 ± 1.26 vs. 5.05 ± 1.21; p < 0.05) were observed. In the long term, a variety of different tendencies was found, highest in KSS Function with 76.32 ± 16.49 (app group) vs. 67.67 ± 16.57 (control group) (p = 0.130). Additionally, patients in the app group required less painkillers (10.0% vs. 26.7%) and more likely to participate in sports (65.0% vs. 53.3%).ConclusionsAn app-based knee trainer is a promising tool in improving functional outcomes such as KSS function score and VAS after TKA.Level of evidenceLevel II, prospective randomized control trial.
Highlights
New app-based programs for postoperative rehabilitation have been developed, but no long-term study has been published to date
We focused on the active range of motion; whereas, in the long term, the functional outcome was prioritized applying the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Knee Society Score (KSS)
Sixty patients gave consent for inclusion in the prospective randomized trial, who were allocated into the control group (n = 27) and the app group (n = 33)
Summary
New app-based programs for postoperative rehabilitation have been developed, but no long-term study has been published to date. A prospective randomized control trial with 2-year follow-up was performed to evaluate the effectiveness of app-based rehabilitation (GenuSport) compared to a control group after total knee arthroplasty (TKA). Twenty-five patients were lost to follow-up, leaving 35 patients undergoing TKA for inclusion In this group, twenty patients received app-based exercise program and 15 were randomized to the control group. A major aspect of achieving functional outcome is the effectiveness of rehabilitation program, in addition to having appropriate anesthesia and sound surgical techniques This includes “enhanced recovery after surgery” (ERAS), which allows early mobilization on the same day of surgery as well as neuromuscular electrical stimulation (NMES) [2, 3]. Mobile e-health app has been shown to improve pain control and decrease opiate use in the initial postoperative period in some instances [5]
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