Knee replacement patients benefit from revolutionary virtual therapy

Posted: 06/09/2016

The first European trial of a revolutionary new tracker device is underway in the UK to try to improve the rehabilitation of patients who have undergone knee replacement surgery. A targeted daily exercise regime following knee replacement is known to improve the outcome for patients.

While effective rehabilitation is likely to lead to a greater range of movement in the new joint and reduced pain, pressure on NHS resources leaves many patients frustrated by the limited post-operative therapy available, limiting the potential benefit of their knee replacement.

A trial is now underway at the Golden Jubilee National Hospital in which trackers are attached to patients' legs to provide feedback on their post-operative exercise regime. After their discharge from hospital, these patients have access to a computer programme that takes data from the trackers.

The programme guides the patient through a daily exercise regime. It outlines the aim and technique for each exercise and provides the patient with tailored visual feedback to improve technique. It also records progress, both in terms of the quality and quantity of exercise, providing reports to the patient and clinicians that set out the effectiveness of the rehabilitation.

By six weeks after a knee replacement, patients should be aiming to achieve at least 90° flexion in the new knee but they often do not see a consultant in the meantime. The new system enables the consultant to review the motion tracker data remotely to assess patient progress. It also offers remote video calls between patients and clinicians to discuss any concerns, rather than the patients having to wait until their next physiotherapy or out-patient appointment.

To date, the trial has been limited in numbers but the patients involved have found it easy to use and almost all agreed it was beneficial in improving post-operative follow-up. Compared to a control group, the early indications are that the remote tracker also improves the overall outcome, with those using the system showing greater improvement in both extension and flexion of the replacement knee on assessment six weeks after their operation.

Andrew Clayton, a member of Penningtons Manches' clinical negligence team, comments: "This remote tracking system has the potential to deliver significant benefit to patients and clinicians. The visual feedback helped patients to improve the effectiveness of their rehabilitation and encouraged them to exercise, ultimately improving their outcome. It also reduces the number of outpatient appointments and the amount of time each patient needs from their consultant and physiotherapist.

“It also seems likely that, if patients' overall outcome is improved, their need for other NHS services post-operatively will be less, benefiting the NHS more widely. Further testing will hopefully see wider roll out of this revolutionary approach to post-operative therapy."

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