Not every patient needs in-person physical therapy after joint replacement–and a growing body of evidence supports that. For ideal candidates, digitally guided, home-based rehabilitation can deliver outcomes comparable to traditional, supervised PT. These patients can successfully recover with remote support, provided they have access to the right tools and guidance, including a robust digital patient engagement platform and care coordination platform.
Force Therapeutics’ digital care management platform enables this approach by offering evidence-based, personalized, PT-developed rehabilitation pathways, seamless care coordination, and integrated remote patient monitoring. For the right patients, this means a convenient, high-quality alternative to in-person therapy–without compromising outcomes.
More Patients Skipping Physical Therapy
Force Therapeutics has previously demonstrated that the percentage of patients discharged directly home with only outpatient or no physical therapy rose from 13% to 62% for knee replacements and from 10% to 74% for hip replacements in the span of 10 months. This was observed across major orthopedic practices: one saw home discharges climb from about 20% to 50% over 2 years, and another reported that 90% of their joint-replacement patients go straight home or to outpatient PT.
While many studies (such as those below) demonstrate that shifting to virtual physical therapy can be done without sacrificing patient outcomes, it is still crucial to actively monitor patient outcomes to ensure that any such shift is concurrent with strong functional outcomes and high patient satisfaction.
Why Patients and Providers Are Opting Out of Supervised PT
1. Advances in Surgical Techniques and Pain Management
Modern minimally invasive approaches and enhanced pain management approaches allow patients to ambulate almost immediately post-op. Some surgeons report that only 10% of knee-replacement patients ultimately require formal PT; the rest “walk around” at home with comparable outcomes.
2. Comparable Outcomes with Home Exercises
A systematic review of randomized trials found no clinically significant benefit of supervised PT over unsupervised home exercise after total knee arthroplasty. Likewise, ultra-early (< 12 h) in-person PT produced only marginal reductions in length of stay and no functional gains over PT started within 24 hours.
A host of other studies has also demonstrated that remote and digitally enabled physical therapy yields similar outcomes as in-person physical therapy at lower costs to both patients and the healthcare system, including:
- A Remote Physical Therapy Program Demonstrates Similar Outcomes Compared to In-Person, Supervised Physical Therapy After Same-Day Discharge Total Knee Arthroplasty: A Randomized Clinical Trial
- Formal Physical Therapy Following Total Hip and Knee Arthroplasty Incurs Additional Cost Without Improving Outcomes
- Self-Directed Home Exercises vs Outpatient Physical Therapy After TKA: Value and Outcomes Following a Protocol Change
- Formal Physical Therapy May Not Be Necessary After Unicompartmental Knee Arthroplasty: A Randomized Clinical Trial
- 2018 John N. Insall Award: Recovery of Knee Flexion With Unsupervised Home Exercise Is Not Inferior to Outpatient Physical Therapy After TKA: A Randomized Trial
- Formal Physical Therapy After THA Is Not Required: A Randomized Controlled Trial
3. Preoperative Education and “Prehab”
Additionally, preoperative PT education can shift the rehabilitation learning curve earlier, reducing postoperative PT visits by one to two sessions. This early engagement helps patients build familiarity with exercises and movement expectations, leading to improved confidence and adherence after surgery. For select patients, especially those with no comorbidities and low-risk profiles, preoperative education can also contribute to better pain management, faster return to functional independence, and lower overall healthcare costs.
Considerations for Skipping In-Person Physical Therapy
- Safety Concerns: Unsupervised physical therapy is only appropriate for select patients, as determined by their physicians. The care team is the ultimate decision maker, and their clinical expertise is essential in triaging patients and determining the most appropriate care pathway. High-risk patients may miss signs of complications–such as wound issues, falls, or pain mismanagement–and should typically receive in-person support or regular clinical check-ins to ensure their safety and recovery stay on track.
- Variable Adherence: Without structured oversight, some patients may under-perform exercises or skip them entirely, risking stiffness and functional deficits. Utilizing a digital solution that has a track record of high patient engagement can reduce variation and raise care plan adherence.
- Lack of Standardized Pathways: Inconsistent home regimens can introduce unwarranted care variation, undermining quality benchmarks and health system care coordination efforts. High-quality, clinically proven digital care management can solve this problem by personalizing care pathways based on each patient’s risk stratification and medical history, reducing variation in outcomes at scale. Most digital care solutions are not equipped with sufficient intelligence or capabilities to deliver truly tailored patient experiences and care plans based on each patient’s needs. Therefore, careful evaluation of patient engagement solutions, care coordination platforms, and digital health applications is highly recommended to ensure ongoing patient safety and optimized patient experiences.
Leveraging Digital Care Solutions to Address Gaps
By integrating a digital care solution and postoperative care platform, health systems can:
- Standardize Evidence-Based Protocols: Digital care pathways ensure every patient follows a clinician-designed recovery plan.
- Enhance Patient Engagement: Automated reminders, instructional videos, and interactive check-ins boost adherence to home exercises.
- Enable Remote Monitoring: Clinicians can track patient-reported outcomes and activity levels, intervening when patients report high pain or low engagement.
- Optimize Clinical Workflows: Dashboard analytics identify at-risk patients and streamline care coordination, aligning with clinical workflow optimization goals.
Force Therapeutics: A Comprehensive Digital Patient Engagement Platform
Force Therapeutics is a patient-centric digital health solution that seamlessly integrates preoperative education, postoperative PT-developed rehabilitation, and remote patient monitoring, serving as your one-stop shop for comprehensive remote patient engagement and recovery.
Key features include:
- Gold-Standard Patient Education: A robust library of clinically-validated PT-developed content and videos, customizable to accommodate various protocols and patient profiles.
- Personalized Care Plans: Pre-operative optimization and post-operative recovery journeys exercise protocols tailored to surgical type and patient risk profiles, all created by accredited physical therapists.
- Automated Touchpoints: In-app reminders, educational alerts, and patient awards and gamification features support consistent patient engagement.
- Clinical Intelligence: Aggregate and patient-level data dashboards drive well-informed clinical decisions and facilitate real-time care plan adjustments.
- Seamless Integration: Seamless coordination with EHRs enables the display of actionable recovery insights directly in the patient record.
Conclusion and Next Steps
As more joint replacement patients skip traditional physical therapy and leverage virtual PT at the direction of their providers and care teams, a digital care management platform becomes essential to maintain quality, efficiency, and, most importantly, patient safety. Force Therapeutics’ integrated solution empowers providers to deliver scalable and standardized care while remaining patient-centric.
Ready to reduce variation, enhance recovery, drive value, and transform your joint replacement care pathways? Book a demo today:
