OBJECTIVES: To assess the usability of an early digital platform (tablet application + wearable activity tracker) designed to enhance recovery for elderly patients undergoing TKA surgery during hospitalization.

METHODS: Adult Japanese patients scheduled to undergo unilateral, primary TKA were prospectively recruited at a single center between September 2018 and July 2019 in Japan, following ethics approval. Following informed consent, patients were assigned 2:1 to the digital group (standard of care [SOC] + digital platform [DP]) versus SOC alone. Self-knowledge and adoption were evaluated before and after surgery. Patients and physicians were interviewed to understand their perspectives on the usability of the DP.

RESULTS: Nine patients in the DP group (mean age 68.2 years; 55.6% female) and five patients (70.6 years; 100% female) in the SOC group completed the study. At baseline, 13/14 (90%) patients in both groups reported that they lacked enough information about rehabilitation to manage their post-surgical condition. Similarly, all patients lacked pre-operative knowledge about important complications associated with TKA. After surgery, 6/9 (67%) patients attributed improved ability to self-manage their condition to the DP. Forty-four percent of DP patients felt that the application improved their ability to communicate with their doctor. 4/9 (44%) patients indicated that they would continue using the DP on their personal device upon discharge. Usability issues included those related to font size, data entry, device navigation. Thus, while 8/9 (89%) of patients would recommend the DP to others, 5/9 (55%) of these would do so only with improved usability. Physicians mentioned the DP could save consultation time as it provided valuable health education for patients.

CONCLUSIONS: This small pilot study found the DP may improve self-efficacy and communication with doctors during hospitalization after TKA, albeit with improvements required to improve usability. It also may reduce physician consultation time related to patient education.