Today we have the pleasure of hosting Dr. David Fisher for a Q&A about data collection, patient education and engagement and how these areas help improve his patient’s outcomes. Dr. Fisher is an orthopedic surgeon, fellowship trained in arthritis surgery and total joint replacement. Additionally, he is the previous Director of Total Joint Service at Methodist Hospital and past president of OrthoIndy. He has also worked as a part of multiple knee and hip replacement design teams, and travels around the world educating and speaking on total joint replacement.
We collect information on all of our patients who undergo knee surgery, whether it is unicompartmental knee, total knee, or revision knee procedures. This data includes x-ray analysis, knee function and pain scores with validated tools such as the KOOS and Knee Society scores, as well as generic scoring with EQ5D, and patient satisfaction surveys. This information is maintained in a database and our patients are followed longitudinally. I have been doing this for nearly 30 years.
This data allows us to compare patient outcomes from different surgical procedures, and to see how they fare over time. Most major knee procedures show a definite improvement over the first 12 months after their surgery. They should then enjoy years of continued improvement.
Providing feedback is important to patient recovery after knee surgery. They become much more engaged and optimistic when they see improvement in knee pain and function.
We educate our patients with procedure specific literature, electronic video education, and classes that they can attend prior to surgery. Patients who are well informed and know what to expect clearly do better with their rehabilitation than patients who are not. We can see this in our outcomes and ultimately patient satisfaction surveys.
The benefits of patient engagement are tremendous. Motivated and educated patients are much easier to care for and will likely have a better clinical result from their procedure. These patients clearly want to get better, are competitive in their rehabilitation, and goal oriented. These are the driving forces that push them to recover and knowledge of their progress will no doubt enhance this.
I try to get patients back to the activities they enjoyed before developing arthritis in the knee, whether this was sporting activities, social activities, biking, or hiking in the mountains. They are welcome to engage in these activities as the knee recovers and their knee function improves. Quality of life includes the ability to engage in the things you enjoy and knee surgery can clearly improve that in patients with arthritis.
I think tools like the RecovAware Knee app can empower the patient to enhance their recovery. As not all patients are alike, individual recovery will vary quite a bit. Rather than the standard physical therapy regimen, a Knee application can help patients to monitor their own progress, help them set goals, give them positive feedback, and compare their recovery to an expected “normal” recovery.