Post-market prospective, multi-center longitudinal study to determine if mobile application-guided education and exercise paired with accurate and sensitive activity monitoring, captured from consumer wearables, can provide a viable (and potentially improved) alternative to current standard of care physical therapy for hip and knee arthroplasty.
This is a post-market prospective, multi-center longitudinal study in subjects undergoing primary total knee arthroplasty (TKA), total hip arthroplasty (THA), or partial knee arthroplasty (PKA). The study objective is to determine if mobile application-guided education and exercise paired with accurate and sensitive activity monitoring, captured from consumer wearables, can provide a viable (and potentially improved) alternative to current standard of care patient education and physical therapy for hip and knee arthroplasty. The study will be conducted in phases. The first phase (N = 300) will consist of a pilot cohort of subjects and will primarily serve to determine site study staffing needs and time required for various elements of study execution. The second phase (N = 1,000, RCT) will consist of a randomized controlled subject cohort and will compare outcomes of mobile application-guided exercises and activity with standard of care (SOC) physical therapy. The third phase (N \~ 10,000 including subjects from both Phase I and the study arm from RCT/Phase II) will seek to collect enough data to enable the creation of decision support algorithms for outcomes of joint replacement. All subjects will undergo a TKA, THA, or PKA using SOC procedures and commercially-available devices as part of their clinical care. Subjects will then complete prescribed post-operative activities, such as physical therapy, according to SOC or performing exercises as scheduled through the mymobility app. In office assessments will be conducted at approximately 30 days prior to surgery, 30 days after surgery, and 3 months after surgery. Virtual assessments (including subject questionnaires and recording of adverse events) will occur at approximately 6 months and 1 year post-op. February 2022 update: Eligibility criteria for new patients includes total knee and partial knee arthroplasty surgeries. Previously enrolled total hip arthroplasty patients will remain in the study for follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
6,559
The mymobility mobile application is a mobile software platform designed to facilitate remote episode of care management and asynchronous communication between the provider care team and their patient via provider-approved care plans and engagement communications. Current care pathways have been developed for: Total Hip Replacement, Total Knee Replacement and Partial Knee Replacement. Designed for the orthopedic population, mymobility also integrates wearable data from the Apple Watch into provider dashboards, providing enhanced understanding and monitoring of patients throughout the episode of care.
Phase II (RCT): Readmissions
The number of subjects with a readmission within 30 days after knee or hip replacement surgery.
Time frame: 30 Days
Phase II (RCT): Knee Injury and Osteoarthritis Outcome Score - Joint Replacement (KOOS, JR)
The KOOS, JR score ranges from 0 to 100 where 0 represents total knee disability and 100 represents perfect knee health.
Time frame: 90 Days
Phase II (RCT): Hip Disability and Osteoarthritis Outcome Score - Joint Replacement (HOOS, JR)
The HOOS, JR score ranges from 0 to 100 where 0 represents total hip disability and 100 represents perfect hip health.
Time frame: 90 Days
Phase II RCT: EQ-5D-5L
The EQ-5D is a standardized instrument widely used to measure health status. It is a self-reported assessment of the participant's quality of life. The score ranges from a minimum score of -0.573 to a maximum score of 1, with higher scores indicating higher health utility. Negative numbers correspond to a self-assessed health state worse than being dead.
Time frame: 90 Days
Phase II (RCT): Manipulation Under Anesthesia (MUA)
The number of subjects with a manipulation under anesthesia (MUA) within 90 days after knee replacement surgery.
Time frame: 90 Days
Phase II (RCT): Timed Up and Go (TUG)
Timed Up and Go Test: The time to rise from a chair, walk 10 feet, turn around, walk back to the chair and sit down.
Time frame: 90 Days
Phase II (RCT): Single-Leg Stance (SLS) Test
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Sah Orthopaedic Associates
Fremont, California, United States
Hoag Orthopedic Institute
Irvine, California, United States
Stanford University
Redwood City, California, United States
Colorado Joint Replacement
Denver, Colorado, United States
Panorama Orthopedics & Spine Center
Golden, Colorado, United States
Foundation for Orthopedic Research and Education
Temple Terrace, Florida, United States
Cleveland Clinic Florida
Weston, Florida, United States
Emory University
Atlanta, Georgia, United States
Rush University Medical Center
Chicago, Illinois, United States
Midwest Center for Joint Replacement
Indianapolis, Indiana, United States
...and 20 more locations
Balance Test while standing on a single leg. Three tests are performed and the best of the three times is recorded. The maximum time for this test is 60 seconds.
Time frame: 90 Days
Phase II (RCT): Subject Satisfaction
Comparison of subject satisfaction survey results between the study groups. The Knee Society Scoring System (KSS) satisfaction score ranges from 0 to 40, with higher scores indicating greater satisfaction.
Time frame: 90 Days
Phase II RCT: Urgent Care Center and Emergency Room Visits
The number of subjects with urgent care visits or emergency room visits within 90 days after knee or hip replacement surgery.
Time frame: 90 Days
Phase I (Pilot): Knee Injury and Osteoarthritis Outcome Score - Joint Replacement (KOOS, JR)
The KOOS, JR score ranges from 0 to 100 where 0 represents total knee disability and 100 represents perfect knee health.
Time frame: 90 Days
Phase I (Pilot): Hip Disability and Osteoarthritis Outcome Score - Joint Replacement (HOOS, JR)
The HOOS, JR score ranges from 0 to 100 where 0 represents total hip disability and 100 represents perfect hip health.
Time frame: 90 Days
Phase III (Correlative): Knee Injury and Osteoarthritis Outcome Score - Joint Replacement (KOOS, JR)
The KOOS, JR score ranges from 0 to 100 where 0 represents total knee disability and 100 represents perfect knee health.
Time frame: 90 Days
Phase III (Correlative): Hip Disability and Osteoarthritis Outcome Score - Joint Replacement (HOOS, JR)
The HOOS, JR score ranges from 0 to 100 where 0 represents total hip disability and 100 represents perfect hip health.
Time frame: 90 Days