A new mode of follow-up scale assessment for total knee arthroplasty based on a rehabilitation application

BACKGROUND: The follow-up scales following total knee arthroplasty (TKA) are numerous and complex, which may adversely affect completion rates. The growing popularity of rehabilitation applications facilitates the collection of patient information at any time. However, no efforts have been made to leverage this capability to enhance follow-up scales. OBJECTIVE: This study aimed to develop a novel mode of scale follow-up utilizing rehabilitation applications. The completion rate of this new mode was assessed, and the differences in assessment results between the two methods at various time points were analyzed comparatively. METHODS: In this prospective study, a total of 120 patients who underwent total knee arthroplasty (TKA) were enrolled using the Vital Health app. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Knee Society Score (KSS) scales were combined to create a set of 31 questions. Four to five questions were sent to patients daily via the app, and patients responded during interactive question-and-answer sessions. WOMAC and KSS scores were aggregated weekly. During the 6-week and 12-week outpatient follow-ups, the complete WOMAC and KSS questionnaires were administered, with all questions answered in a single session. RESULTS: The completion rate for the new follow-up mode at both 6 weeks and 12 weeks post-surgery was 100%. There was no significant difference in the evaluation scores of patients following TKA surgery between the new mode and conventional follow-up methods. Both the Interclass Correlation Coefficient (ICC) and the Bland-Altman plot demonstrated a strong consistency in the assessment scores between the two follow-up strategies. CONCLUSIONS: The new survey mode, based on the rehabilitation app, demonstrated a high level of consistency with the conventional mode of scale investigation regarding assessment scores. This innovative approach has the potential to replace the traditional scale. Furthermore, the new mode significantly reduces the response burden on patients while enhancing the completion rate of follow-up assessments.