DALLAS — Patients who participated in virtual physical therapy after total knee arthroplasty had significantly lowered health care costs and similar effectiveness and safety compared with usual care, according to a poster presented at the American Association of Hip and Knee Surgeons Annual Meeting.
Richard C. Mather, III, MD, MBA, and colleagues randomly assigned 306 patients undergoing total knee arthroplasty to participate in either a virtual physical therapy program with an avatar coach, in-home 3-D biometrics and tele-rehabilitation or usual physical therapy care in the home or outpatient clinic. The primary outcome was total health care costs for 12-weeks post-hospital, while secondary outcomes included 6- and 12-week KOOS scores, 6-week knee extension, knee flexion, gait speed and 12-week safety.
Results showed 287 patients completed the trial, with 143 patients receiving virtual physical therapy and 144 receiving usual care. At 12-weeks post-discharge, researchers found lower costs among patients who underwent virtual physical therapy. Patients undergoing usual care had mean costs that were $2,745 higher compared with virtual physical therapy, which researchers noted was driven by a higher number of urgent care and emergency room visits, as well as more inpatient post-acute care stays. According to results, virtual physical therapy had no differences in 6- and 12-week KOOS scores, 6-week knee extension, flexion and gait speed and 12-week pain and hospital readmissions vs. usual care. Results showed 19.4% and 14.6% of patients in the virtual physical therapy and usual care groups, respectively, reported falls. Researchers noted patients in the virtual physical therapy group had a high likelihood or recommending the program to other patients.
“[Virtual Exercise Rehabilitation In-Home Therapy] VERITAS shows that virtual exercise technology with physical therapist support relative to traditional TKA rehabilitation can substantially reduce the cost of care while maintaining functional outcomes and lowering the readmission rate,” Mather told Healio.com/Orthopedics. “The results further underscore the role of value-based payment models in creating incentives for providers to utilize cost saving care management models with digital health technology.” – by Casey Tingle
Bettger J, et al. Poster 229. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 1-4, 2018; Dallas.
Disclosure: Mather reports he is a paid consultant for KNG Health Consulting and Stryker; and receives research support from Reflexion Health and Zimmer.