To evaluate the feasibility of using a smartphone-based care management platform (sbCMP) and robotic-assisted total knee arthroplasty (raTKA) to collect data throughout the episode-of-care and assess if intra-operative measures of soft tissue laxity in raTKA were associated with post-operative outcomes.
A secondary data analysis of 131 patients in a commercial database who underwent raTKA was performed. Pre-operative through six week post-operative step counts and KOOS JR scores were collected and cross-referenced with intra-operative laxity measures. A Kruskal–Wallis test or a Wilcoxon sign-rank was used to assess outcomes.
There were higher step counts at six weeks post-operatively in knees with increased laxity in both the lateral compartment in extension and medial compartment in flexion (p < 0.05). Knees balanced in flexion within < 0.5 mm had higher KOOS JR scores at six weeks post-operative (p = 0.034) compared to knees balanced within 0.5–1.5 mm.
A smartphone-based care management platform can be integrated with raTKA to passively collect data throughout the episode-of-care. Associations between intra-operative decisions regarding laxity and post-operative outcomes were identified. However, more robust analysis is needed to evaluate these associations and ensure clinical relevance to guide machine learning algorithms.
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This work was supported by Zimmer Biomet, Inc.
The data was completely anonymized and access to data was restricted by the entity’s privacy and data processing teams. As such, the study does not meet the criteria for human subject research; regardless, an institutional review board approved the study with a waiver of consent and authorization (IRB # 20222582).
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Jess Lonner—Royalties, paid consultant, research support: Zimmer Biomet and Smith and Nephew; paid consultant, stock or stock options, research support: Force Therapeutics. Roberta E. Redfern—employee of Zimmer Biomet. Mike B. Anderson—employee Zimmer Biomet; OrthoGrid Systems Stock or Stock Options. Dave Van Andel—employee of Zimmer Biomet. James Ballard—paid consultant; paid presenter or speaker Zimmer Biomet. Sebastien Parratte—Royalties: Zimmer Biomet and Newclip Technics, paid consultant: Zimmer Biomet.
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Lonner, J.H., Anderson, M.B., Redfern, R.E. et al. An orthopaedic intelligence application successfully integrates data from a smartphone-based care management platform and a robotic knee system using a commercial database. International Orthopaedics (SICOT) 47, 485–494 (2023). https://doi.org/10.1007/s00264-022-05651-3