We've developed a new digital platform for total knee replacement rehabilitation which aims to assist patients manage their surgery preparation and speed up recovery.

The challenge

Patients aren't completing rehab following total knee replacements

Total knee replacement (TKR) is a procedure that has been rising steadily in recent years. In fact there was a 77 per cent increase in TKR surgeries from 2003 to 2014 in Australia, and this trend is likely to continue due to factors such as the aging population and increased obesity rates.

Studies have shown that rehabilitation exercises following TKR surgery can lead to faster recovery times, however many patients fail to implement an effective preparation or rehabilitation plan.

Our response

A digital platform to help patients manage their rehab

We've developed and are trialling digital rehab platform to support more TKR patients completing rehabilitation programs.

Screen shot of iphone rehab app home screen

Our new TKR rehab app aims to assist patients manage their surgery preparation and speed up recovery.

The rehab platform includes a smartphone application (app) which provides patients with practical information including physiotherapy demonstration videos, pre-surgery checklists, reminders and supportive information in text, video and audio format. The technology also includes a wearable activity tracker to encourage basic exercise, track sleep and self monitor progress.

In addition, the platform links to a website where clinicians can configure individual physiotherapy programs and monitor patient progress remotely.

The results

Bridging the communication gaps between clinicians and patients

We've developed a digital tool to support patients and care givers through the total knee replacement journey.

This includes information on the surgery and preparation, patient coaching, assistance with physiotherapy plus use of wearables to motivate patients to self-monitor and engage. The study will show us how the technology impacted patients and carers.

Launched in November 2016, up to 300 patients will be involved in the trial across five hospitals from multiple states in Australia.

[Music plays and CSIRO logo appears]

[Text appears: CSIRO trials knee replacement surgery app and portal to improve patient recovery]

[Images move through of Phillip walking up to the COSI building, entering the building and entering Dr Michael Hunter’s office]

[Image changes to show Dr Michael Hunter talking to the camera and text appears: Dr Michael Hunter, Orthopaedic Surgeon]

Dr Michael Hunter: Good morning Phillip.  How are you?  Welcome.  Have a seat. 

[Image changes to show Phillip’s face and then the image changes to show Dr Michael Hunter talking to the camera]

Phillip you’re now six weeks after your knee replacement and you’re going very well. 

[Image changes to show a view of the portal on the computer screen]

Through the portal we have in the office I’ve been able to track your progress

[Image changes to show Phillip listening]

which has been fantastic. 

[Image changes to show Dr Michael Hunter talking to the camera and then the image changes to show Phillip listening]

I can see that your pain and the physiotherapy’s going well.  The exercise you’re doing well

[Image changes to show a graph displaying Phillip’s steps on the portal]

but I notice your steps are slightly reduced recently

[Image shows a finger pointing at the graph on the portal and then the image changes to show a side view of Dr Michael Hunter talking]

and there’s one day here in particular note that you’re down to about 1,000 steps. 

[Image changes to show Phillip listening and then talking to the camera]

Can you remember what was happening that day?

Phillip:  Well, the weather hasn’t permitted it (laughs).

[Image changes to show Dr Michael Hunter talking to the camera]

Dr Michael Hunter: The weather has been pretty lousy recently so, I’ll give you that and portal also mentions you’re a bit stiff. 

[Image changes to show a range of motion graph on the portal]

Your range of movement’s reduced.  How are you going with that?

[Image changes to show Phillip talking to the camera]

Phillip:  I’m doing them every day.  It’s just pushing through the initial pain

[Image changes to show Dr Michael Hunter listening]

with the exercises and stretching.

[Image changes to show data on the portal and then the camera zooms in on dots on the portal displaying pain, rom, steps and physio]

Dr Michael Hunter:  Right OK.  The green dots here on the screen show that you’re doing very well in a couple of areas

[Image changes to show Phillip listening]

but there are a couple of red dots here that are highlighted that I’ve been keeping an eye on

[Image changes to show Dr Michael Hunter talking to the camera]

that document that your range of motion’s just slightly decreased and obviously after a knee replacement

[Image changes to show a range of motion bar graph on the portal]

we’re very keen for that to be worked on, to be pushed, to try and increase that range of motion. 

[Image changes to show Phillip listening]

I can keep an eye on you every day

[Image changes to show a hand pointing at data on the portal and then the data scrolls through on the portal]

and observe that and observe your response to the physiotherapy. 

[Image changes to show Phillip listening]

I understand now you’ve got an appointment with your physiotherapist. 

[Image changes to show data scrolling through on the portal]

He’s going to take you through the next six weeks of your physio and rehab programme

[Image changes to show Dr Michael Hunter talking to the camera]

while I keep an eye on you on the portal.

[Image changes to show a rear view of Phillip and Jamie Exton entering the room]

Jamie Exton: Well, hi Phil. 

[Image changes to show a view of Jamie Exton talking to the camera and text appears: Jamie Exton, Physiotherapist]

You’re halfway through your treatment and I hear you’ve just been to see Dr Hunter.  How did that go? 

[Image changes to show Phillip and Jamie Exton talking together]

He was happy with everything?

Phillip: Yeah.

[Image changes to show Jamie Exton talking to the camera]

Jamie Exton:  OK.  Well, obviously you know you’re part of a trial into using this app and the portal that we’ve developed with total knee joint replacements. 

[Image changes to show a back view of Jamie Exton talking while Phillip listens]

So, over the next six weeks you’re going to notice that every week

[Image changes to show a view of a finger scrolling through information on a Smartphone]

we’re going to be updating your exercises and we’ll be using the portal for that.  As far as the app goes you’ve probably noticed already that there’s a lot of education material in there.  Have you been using that educational material? 

[Image changes to show Jamie Exton talking to the camera]

I mean the purpose of that is it follows you as you journey through having a knee joint replacement before and after your surgery. 

[Image changes to show a view of a finger scrolling through information on a Smartphone]

So, you’ll notice that when you get to the four-week mark, you’ll notice that the education material changes and it really talks about nutrition and it talks about

[Image changes to show Jamie Exton talking to the camera]

some of the other benefits of exercise and wellbeing. 

[Image changes to show the Smartphone being turned sideways and data being displayed]

If you actually turn the phone sideways, you’ll see that you can actually see your last week’s data.  So, you can actually see how you’re going with your steps.  Have you ever tried that?

Phillip:  Yeah.

[Image changes to show Jamie Exton talking to the camera]

Jamie Exton:  It’s a really good feature.  We’re going to be changing a few of your exercises now and

[Image changes to show a view of a finger scrolling through information on a Smartphone and then the Smartphone being turned sideways and displaying an exercise]

we’re going to be trying to really press on and improve your physical function over the next little while.  Today we’re going to focus a lot more on the straightening exercises and

[Image changes to show Jamie Exton talking to the camera]

I’m going to use the app to help us with that. 

[Image changes to show Phillip listening and Jamie Exton talking]

Phillip: OK.

[Image changes to show Phillip’s feet on a stool and then the camera zooms up to show Phillip’s outstretched leg]

Jamie Exton:  I want you to lean forward and try and straighten the back of your knee.  Feel a stretch through here through the back of this hamstring.  This is a variation of the stretch that we just showed you.  You’re one of many people on this trial. 

[Image changes to show Jamie Exton talking to the camera]

The CSIRO developed this trial. 

[Image changes to show Phillip listening and Jamie Exton talking]

We’re going to be really trying to improve this software over the next little while.

[Image shows a back view of Phillip walking along the front of a building]

[CSIRO logo and text appears: Australia’s innovation catalyst]

Total Knee Replacement App

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