Authors: Mikayla Emery McGrath2, Hallie R Lucas1, Donna McNeill1, Sarah Ulcoq2, David A Dodgin1, Eric Matthew Heinrich1
1Muve Health
2Force Therapeutics
Abstract
Introduction
Total Joint Arthroplasty (TJA) continues to shift to same-day and nonhospital-based TJA, with a projected 77% growth over 10 years. Prior research has demonstrated safety and efficacy of Virtual PT in THA, however limited research has examined same-day discharge patients. The purpose of this study is to compare engagement, PROMs, and satisfaction in TKA patients based on physical therapy(PT) utilization.
Methods
Between January 2018 and February 2020, outpatient cases at a single institution were enrolled in a comprehensive patient engagement program that assigned a RN navigator preoperatively to follow patients through recovery. They have access to Virtual PT, education, communication, and outcomes collection. Patient reported PT utilization was segmented to retrospectively analyze (level III) the impact of virtual PT only versus OPT + virtual PT on engagement, PROMs, and satisfaction.
Results
Out of 218 TKA patients, 33% (71) attended OPT (Mean 14.52 sessions) and 147 utilized Virtual PT only. No significant baseline differences in gender, age, BMI, preoperative platform engagement, Virtual PT and OPT + Virtual PT patients. Virtual PT only patients had significantly higher VR-12 MCS at baseline (54.80 v 51.30, p=0.03) No significant difference in postoperative video views (86.99 v 77.32,p=0.55), postoperative exercise views (60.29 v 51.01,p=0.54), or postop logins (33.47 v 28.15,p=0.15). Virtual PT only patients had significantly higher KOOS Jr Scores at 6 months (77.57 v 73.24, p=0.02), VR-12 PCS 12 weeks (42.18 v 39.02, p=0.01) and 6 months (46.55 v 43.32, p=0.02) postoperatively. Virtual PT only patients had significantly higher procedure satisfaction (4.74 v 4.32, p<0.01) on a scale of 1-5.
Conclusion
Patients who utilized Virtual PT only, had better initial functional scores that equilibrated by 1 year postoperatively. Implementation of a comprehensive patient engagement program allows for utilization of Virtual PT as an effective alternative to OPT in same-day and non-hospital-based TKA patients.