Smart implantable devices are associated with reduced 90-day acute care utilization and cost following total knee...

Remote monitoring has been correlated to reduced acute care usage (emergency department (ED)) in cardiovascular, diabetes and COVID domains. Correspondingly, the use of smart implantable devices (SID) in total knee arthroplasty (TKA) may lead to reduced acute care usage in orthopedics.

Retrospective claims data from a nationally representative, third-party claims aggregator were analyzed for ED and hospital admission incidence and cumulative 90-day costs. Patients who received an SID were identified and matched 1:2 with patients who received a traditional knee prosthesis. A subgroup of patients with complete longitudinal claims data for days 91-365 were analyzed for cost comparisons. Chi-squared tests were used to compare acute care incidence and Wilcoxon rank sum tests were used to compare costs.

The analysis included 1621 patients with SID knees (1709 TKAs) and 3041 patients (3418 TKAs) implanted with traditional knees. Cumulative incidence of ED visit (SID: 11.4 %; control: 15.6 %), hospital admission (SID: 6.0 %; control: 8.8 %), or any acute care (ED or hospital admission) (SID: 14.1 %; control: 19.2 %) was significantly lower in the SID group (p < 0.05). Median total cost of all healthcare services from the day after surgery to day 90 was significantly lower in the SID group ($3747) than the controls ($5629), representing 61 % of the cost of control patients. SID patients also had lower costs during day 91-365 ($5322 and $8,454, respectively).

Use of SIDs in primary TKA was associated with fewer ED visits and hospital admissions, as well as lower 90-day total healthcare costs. These cost reductions reflect both a lower incidence of unplanned care and lower costs per patient. These findings support the potential of implant-derived recovery data to enhance care coordination, align postoperative management with patient expectations, increase patient confidence in their health status and reduce the burden of post-TKA acute care.