January 01, 2014
4 min read

Surgeon created app provides resource for knee replacement patients

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When this column began 2 years ago, we observed that most apps were published by companies and organizations that promoted medical devices, tools or products. However, as the app culture has evolved, we have seen an increasing number of physicians, and orthopedic surgeons in particular, venturing into the world of app development. This month, we sat down with orthopedic surgeon Brian R. Hatten, MD, to learn about his app: My Knee Guide.

Matthew DiPaola, MD; and Orrin I. Franko, MD

Matthew DiPaola, MD; and Orrin I. Franko, MD: Please tell us about yourself and your app.

Brian R. Hatten, MD: I have been practicing as a general orthopedic surgeon for 9 years at the Orthopaedic Clinic of Daytona Beach in Florida. I recognized that as my joint replacement practice became busier, I started seeing more patients present to the office with research they had performed online about their upcoming knee arthroplasties. I found that online resources were somewhat disjointed and outdated, and usually not authored by an orthopedic surgeon. It was at that time, in January 2012, that I became interested in developing My Knee Guide. I began reviewing as many patient online resources that I could find claiming to provide information about total knee replacement. I quickly realized that with an iPhone app I could deliver better education and more comprehensive resources through an integrated and easy to understand interface. Thus, the project began when I recognized a gap in reliable patient information and I created it as a privately funded endeavor.


Matthew DiPaola


Orrin I. Franko

DiPaola and Franko: What was your goal for this app? How did you know how to implement it?

Hatten: My motivation for building My Knee Guide was to provide a free and unbiased resource for patients considering or going through knee replacement surgery. As you know, knee replacement is a major operation that can be a challenging experience for the patient, both physically and psychologically. Sometimes, patients do not know what to ask their surgeons or know of a starting point to research their options. I wanted to help simplify their experience and empower patients to feel more confident about their options. My app provides the information patients need in an interactive and organized manner.

For example, My Knee Guide creates a custom surgery timeline for each patient that includes checklists, safety alerts and educational resources. I thought it was important to be comprehensive, so we have also included CMS ratings and surveys of hospitals, rehabilitation facilities and home nursing/therapy organizations. In addition, My Knee Guide has a stories section that allows our users to interact and share their knee replacement experiences with others. Each of these tools is not necessarily unique and can be gathered other places, but the app puts all of these features together in an easy interface.

Once I decided to build the app, I had to find an experienced app developer to create my vision. The process from concept to release took a year and a half to complete and required a significant amount of hands on work. There was a huge learning curve, but it was well worth the effort.

DiPaola and Franko: How has this changed your practice?  

Hatten: Although the app is relatively new, I have already seen changes in my orthopedic practice. While building the app, I spent a significant amount of time thinking about knee replacement surgery from the perspective of the patient rather than the surgeon. This experience has helped me become a better listener of my patients and has helped me to understand their individual experiences. Now that the app is completed, patients use the app to learn and ask questions, and it has become a part of our collective experience through their procedures.

For example, I particularly enjoy when my patients come in and use the preop and postop checklist sections. Before the app, my patients would come to the office with their iPhone or iPad and have their own questions written out on the notepad. In these cases, patients typically would not write down the answers as they moved from question to question. I have designed the checklist items in the app such that the patient can now ask a question and simply tap the appropriate answer. Of course, we also allow the user to input more detailed answers or their own individual questions. This helps patients remember my answers when they get home after a visit.

DiPaola and Franko: What are your plans for future development?

Hatten: For now, we are providing updates to the app as needed. However, future improvements will focus on expanding these resources on an accompanying website (www.mykneeguide.com). The website will be released in early 2014. I am excited about the website because it integrates all of the same interactive features and functions of the app. Users will have access to their surgery timeline, notes, contacts and checklists from either the web or the app. The next step after website development will be the creation of an equivalent Android app. This will complete the goal of making My Knee Guide a service that can be accessed anywhere by any user.

Somewhat serendipitously, there was an unintended but beneficial consequence of building the app before the website. I created features for the app such as “X-ray vision” animations and the “My Surgery” timeline specifically because they worked well on the iPhone platform. These have become some of the most useful and informative tools. However, had we started by building the website first, they may have never been considered.

For more information:
Matthew DiPaola, MD, is an assistant professor and shoulder and elbow specialist in the Department of Orthopedics at Wright State University in Dayton, Ohio. He is a writer for iMedical Apps and co-founder of Touch Consult, a developer of team-based medical software to improve signout. He can be reached at matthew.dipaola@wrightstatephysicians.org.
Orrin I. Franko, MD, is a PGY5 orthopedic resident at UC San Diego. He has an interest in promoting mobile technology within orthopedic surgery and founded the website www.TopOrthoApps.com to help surgeons and trainees find the most relevant orthopedic apps for their mobile devices. He can be reached at orrin@toporthoapps.com.
Brian R. Hatten, MD, can be reached at administration@mykneeguide.com.
Disclosures: DiPaola and Franko have no relevant financial disclosures.