Smart knee technology allows care team to remotely monitor patient's recovery

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Orthopedic Health

For more than 15 years, Ronald Gary Woods ended most days with aching knees.

"It was hard walking around. My knees would get sore and were popping and cracking," says Ronald, 63, of Eagle Lake, Minnesota. "It's like everything else, they just wore out."

Ronald tried various treatments, including cortisone shots and nerve ablation, to interrupt pain signals sent to the brain. He planned to wait until retirement for surgical intervention.

"But I was tired of hurting," he says.

Ronald and Jacob Ziegler, M.D., his orthopedic surgeon at Mayo Clinic Health System in Mankato, recommended bilateral knee replacement, a surgery to replace both of his knees at the same time.

Dr. Ziegler had recently become the first surgeon at Mayo Clinic Health System to utilize new sensor technology licensed by Zimmer Biomet through a partnership with Canary Medical. The smart orthopedic implants function just like standard knee replacements, but they include a sensor in the stem anchored in the shin bone that remotely monitors and tracks a patient's recovery by measuring range of motion, steps, stride and other data associated with gait.

Dr. Ziegler explained to Ronald that he could use an app to see his gait and mobility information as he recovered from surgery. The data would be uploaded once daily to Dr. Ziegler's team, helping them monitor how well Ronald was progressing.

"It sounded pretty good," he says. "The doctor said it was for research, too. I thought, 'Why not?'"

According to Zimmer Biomet, Ronald was one of the first known patients in the world to receive single-surgery bilateral smart knee replacements on March 26.

Dr. Ziegler and Cory Couch, M.D., orthopedic surgeon at Mayo Clinic in Rochester, Minnesota, are the only two Mayo Clinic surgeons who have implanted smart knee replacements in patients, but they will become widely available after Mayo Clinic's trial period of the technology.

Remote monitoring is a major benefit in the rural healthcare setting, Dr. Ziegler says. Patients who live a longer distance from the hospital may not have to return for some in-person follow-up appointments during recovery if the smart knee data shows positive recovery metrics.

"The biggest benefit to patients is our ability to monitor their progress with objective data," Dr. Ziegler says. "Historically, we had to do it very, very subjectively. We could see their range of motion, and beyond that, it was just asking, 'How do you feel? Do you feel like you're moving well? Do you feel like you're progressing?' And patients didn't have any way of knowing what normal should be or what to compare it to. We're able to pull up these recovery curves and show them how their data compares to other patients in a cohort and what they can do to progress."

The battery is guaranteed to last 10 years, although many will likely last longer, Dr. Ziegler says. When the battery dies, the knee replacement continues to function like a traditional knee replacement.

Dr. Ziegler is quick to point out that patient privacy is always at the forefront. Real-time data is not collected, and there is no GPS component showing the care team where the patient is located at any time. Patients also can choose to stop uploading data if they no longer want their metrics shared with the care team.

The only criteria for patients who want to receive a smart knee is that they must be comfortable enough with the technology to engage with the app.

The future of the technology is exciting to think about, Dr. Ziegler says. Future versions could have the potential to detect micro motions and subtle temperature changes to identify infection early on or loosening of the implant.

Dr. Ziegler and Ronald agree he's doing well in his recovery, and the data from the smart knee has helped his care team ensure he's been on the right trajectory.

"It's getting better every day," says Ronald, who just several months after surgery was able to get back on his motorcycle. "I won't make it to Sturgis this year, but next year for sure."