Clinical Outcome Improvement in Open-Wedge High Tibial Osteotomy Using the Smartphone Application mymobility®: A Case...

Clinical outcomes following open-wedge high tibial osteotomy (OWHTO) are influenced by factors such as preoperative varus alignment, catastrophic thinking, metabolic syndrome-related diseases, and older age. This report evaluated the effectiveness of mymobility® (Zimmer Biomet, Warsaw, IN, USA), a smartphone application, for patient education and exercise guidance in improving clinical outcomes and catastrophic thinking in a patient exhibiting these risk factors. An 83-year-old man with Kellgren-Lawrence grade 3 knee osteoarthritis underwent OWHTO. Preoperative assessments revealed a Knee Injury and Osteoarthritis Outcome Score (KOOS) of 35 for symptoms, 36 for pain, 45 for activities of daily living (ADL), 10 for sports, and 0 for quality of life (QOL); an Oxford Knee Score (OKS) of 17; and a Pain Catastrophizing Scale (PCS) score of 52, indicating poor clinical outcomes and catastrophic thinking. His daily step count, walking speed, and walking pain on the visual analog scale (VAS) were 849 steps/day, 0.8 m/s, and 50 mm, respectively. mymobility® was used for video-based exercise guidance, compliance monitoring, and chat-based anxiety management. By postoperative day 90, his step count exceeded preoperative levels, reaching 1500-2000 steps/day by day 365. His VAS score was 10 mm, and his walking speed was 1.0 m/s. He had a KOOS of 71 for symptoms, 67 for pain, 72 for ADL, 45 for sports, and 25 for QOL; an OKS of 30; and a PCS score of 17. mymobility®-based patient education and exercise guidance suggested that mymobility® effectively improved clinical outcomes and catastrophic thinking in a patient who underwent OWHTO and was presenting with older age, catastrophic thinking, and metabolic syndrome-related diseases.