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FOTO Rehab Outcomes Blog

Remote Monitoring System after Total Knee Arthroplasty

New ideas are intriguing to me. My lil brain immediately has questions. I highly doubt patients will be able to consistently velcro something on themselves in the same location. Will this matter when monitoring range of motion. Then, is the device mentioned in the abstract really measuring range of motion or the distance between 2 points? Obviously, if it is the distance between 2 points, then the closer they get to each other the more motion achieved. What is the cost associated with the system and the modem? Are there situations where the technology will fail? Are there situations where transmissions are either delayed or fail? 

The article makes valid points about a few pitfalls that occur after an arthroplasty. I do believe it is great to think of solutions. One huge missing component: a comparison between using the device and transmitting information versus status quo. It's intriguing, yet I honestly don't know if it really mattered. (And then if it did matter, was it more of the idea that patients knew that they were being monitored, so they were more exuberant in doing their stretches?)

Below you will find a quick view of the abstract. 


An Intelligent Remote Monitoring System for Total Knee Arthroplasty Patients.



For the first six weeks following total knee arthroplasty (TKA), a patient will attend an outpatient clinic typically seen twice weekly. Here, an exercise regime is performed and improvement assessed using a hand held goniometer that measures the maximum angle of knee flexion, an important metric of progress. Additionally a series of daily exercises is performed at home, recorded in a diary. This protocol has problems. Patients must attend the hospital with assistance since they are not permitted to drive for six weeks following the procedure; appointments are sometimes missed; there are occasionally not enough physiotherapy appointment available; furthermore, it is difficult to be sure that patients are compliant with their exercises at home. The economic and social costs are therefore significant both to the patient and the health service. We describe here an automatic system that performs the monitoring of knee flexion within a domestic environment rather than in a hospital setting. It comprises a master and slave sensor unit that attach using Velcro straps to the thigh and shin above and below the operation wound. The patient performs the prescribed knee exercises whilst wearing the device, during which time it measures and records the angles of knee flexion. The device utilises the Global System for Mobile Communications (GSM) infrastructure to transmit data through the Internet to a secure hospital-based server using an on-board GSM modem. The clinician is then able to view and interpret the information from any computer with internet access and the software. The system does not require the patient to possess a mobile telephone, a computer, or have internet access; the necessary communications technology is completely integrated into the device.

2017 Jun;41(6):90. doi: 10.1007/s10916-017-0735-2. Epub 2017 Apr 18.