Leading your own recovery after joint replacement
The healthcare sector is under significant pressure to empower patients to shape and manage their own care and improve health outcomes.
One of the ways this can be achieved is through freeing up hospital beds by accelerating the discharge of patients who are otherwise fit and healthy and can safely recover in their own home. The demand for hospital beds is of even greater importance during the COVID-19 pandemic, and it is essential to help reduce the risk of contracting the virus to those undergoing hip or knee surgery by reducing the amount of time spent in hospital.
There are around 200,000(1) hip and knee replacement procedures in the UK each year; the typical in-stay duration of these being 2-4 days. Through innovative technology and a paradigm shift in the patient pathway, in-stay can be transformed into patient-led rehabilitation at home with remote support and guidance, positively impacting healthcare system efficiency and productivity.
Linda had a knee arthroplasty in 2019 and used the BPMpathway Range of Motion Sensor during her recovery. Before her operation, she struggled to walk unaided which was reducing her quality of life, leading to the decision for surgery.
Linda fitted the criteria permitting patients to return home on the day of surgery, therefore she was able to recover in the comfort of her own home.
"I had my operation at Calderdale Hospital and I was only there for one day. By 9 o’clock I was ready to go down to theatre, and by 6 o’clock I was on my way home, and that was fantastic"
Before her surgery, Linda was encouraged to complete pre-habilitation exercises to prepare herself in the best way possible via the BPMpathway app. The rehabilitation exercises continued after the surgery with a tailored programme reminding Linda to complete specific flexion and extension exercises three times per day.
"Using the app itself was brilliant, it gave me a guideline of what I should be doing each day. I felt I wanted to do the exercises every day, I wanted to get better as soon as possible. I wanted to get better as fast as I could and get on with my life."
Linda is now fully recovered and enjoying life following knee arthroplasty.
"We’ve just got back from Barcelona. I’ve been doing approximately between 25,000 and 30,000 steps per day with no pain anywhere on my knee whatsoever."
In 2019, Christine had knee arthroplasty and used B. Braun’s BPMpathway during her recovery. Prior to her surgery, Christine was in constant pain, was struggling to walk and had difficulty performing daily activities such as getting out of a chair and going up and down stairs.
In her initial appointment, Christine was asked to join BPMpathway. She was initially discouraged due to not having her own smart device to host the BPMpathway app, however with the help of her husband Malcolm, Christine was able to use his phone to complete her daily rehabilitation exercises.
"It’s very easy to use because the app guides you through the process. It became a challenge to meet the goal every time which is what I need. I wouldn’t have done it had it not been for the sensor. If I had to go into hospital to do the exercises, I would have just done them there. If they told me to do them three times at home I probably wouldn’t have."
The ability to recover at home with the help of the app and sensor was one of the main benefits for Christine.
"I wouldn’t have improved at the rate I did or have the mobility without the pathway. The last thing you want when you’ve just had an operation is to be going backwards and forwards to the hospital and getting in and out of a car."
The personalised rehabilitation programme allowed Christine to recover at her own pace, with the physiotherapist watching remotely from the hospital.
"The physiotherapist kept pushing the programme up as I improved. The goals get harder to reach and it made me more determined to do it. At the end of the day, you want the best mobility that you can get. I can’t find fault with it, I’d recommend anybody to use it."
Christine is now fully recovered and enjoying life after knee arthroplasty.
Nick decided to have his knee arthroplasty after pain was making his job as a rugby coach difficult.
“Although I was fairly happy pre-op, getting to 10,000 steps made my knee sore and swell.”
After Nick’s operation, he was able to return home on the same day to begin his rehabilitation. Although it seemed unusual at first, leading his own recovery was key in inspiring Nick to complete his daily exercises.
“Going home on the same day was interesting and a bit alien to me, I didn’t expect to go home but for my recovery I think it was good.”
“The sensor got you doing your exercises 3 times a day and you could see your progress which is a natural motivation to keep going. It was a massive factor to me recovering as soon as I did.”
The added responsibility pushed Nick to take ownership of his rehabilitation programme, and acknowledge when he was ready to progress to the next stage with remote support from clinicians.
“The rate that I was able to and being allowed to recover at was important to me.
The physio was brilliant, we messaged back and forth regularly when I felt I could step-up my exercise programme without needing to visit the hospital. They would say if it was fine or whether I should stay on the same programme for a few more days.”
The standard orthopaedic pathway includes limited face-to-face physiotherapy sessions 2 to 6 weeks after the operation. Patients learn the exercises during the appointment and are expected to practice them at home, however many forget without the consistent dialogue with the hospital.
“If you just have intermittent hospital physio appointments, it’s easy to lie and say “yeah I’ve been doing this and I’ve been doing that” but with the remote monitoring you have motivation to do the exercises each day.”
Nick’s family were surprised at the rate in which he recovered.
“My wife couldn’t believe how fast I recovered. She’d factored time off work and it wasn’t needed.
Post operatively, I was back to walking and coaching rugby at 12 weeks, and I’ve had no pain since.”