Visual Element: An infographic showing the ecosystem of connected care: "Smart Implant" -> "Patient App" -> "Cloud" -> "Surgeon Dashboard," illustrating the flow of data.

Big Brother is Watching (You Rehab)

The oldest lie in orthopaedics: Surgeon: "Have you been doing your exercises?" Patient: "Yes, three times a day, every day!" (The knee is stiff as a board).

Compliance with rehabilitation is the single biggest variable in surgical outcome. Until now, it was a black box. Wearable Technology and Remote Patient Monitoring (RPM) have blown the lid off that box.

The Technology: What's Available?

We are moving beyond simple step counters.

1. Consumer Wearables (Apple Watch, Garmin, Whoop)

• Metrics: Steps, Heart Rate, Sleep Quality, Asymmetry (Walking Steadiness).
• Pros: Patient already owns it. High adherence.
• Cons: Not medical grade. Can't measure specific joint angles accurately.

2. Smart Braces (e.g., FocusMotion, Breg)

• Tech: Accelerometers and gyroscopes embedded in a knee or shoulder brace.
• Metrics: Range of Motion (Flexion/Extension), Repetition count, time under tension.
• Use Case: ACL reconstruction, TKA.

3. Smart Implants (e.g., Canary Medical / Zimmer Biomet Persona IQ)

• The Frontier: Sensors embedded inside the tibial stem of a knee replacement.
• Metrics: Step count, stride length, walking speed, range of motion.
• Power: Battery lasts 10 years. Data transmits via base station at home.
• Benefit: Zero patient effort required. The ultimate objective truth.

The Psychology: Gamification

Why does this work? It hacks the dopamine reward system.

• Closing the Rings: Patients hate breaking a "streak."
• Competition: Apps that show "You are in the 90th percentile for recovery" drive patients to work harder.
• Accountability: Knowing the surgeon will see the graph at the 6-week visit is a powerful motivator.

Clinical Pearl: Data without context is anxiety. Patients need to know that "bad days" are normal. The dashboard must be interpreted by the clinical team, not just dumped on the patient.

"Pre-Hab" and Predictive Analytics

The real power lies not just in tracking recovery, but in predicting failure.

• The Dip: A sudden drop in step count at 3 weeks might flag a DVT or a wound infection before the patient calls the office.
• The Baseline: Monitoring patients for a month before surgery establishes a true baseline, allowing for personalized recovery goals rather than generic population averages.

Challenges and Ethics

Data Overload

A surgeon with 200 active post-op patients cannot check 200 dashboards daily.

• Solution: AI Exception Handling. The system only alerts the team if a patient deviates from the expected curve (Red Flag).

Privacy

• Ownership: Who owns the data? The patient? The hospital? The implant company?
• Security: Can a smart knee be hacked? (Theoretically yes, but practically low risk).

Conclusion

Wearable technology shifts orthopaedics from an episodic model of care (see you every 6 weeks) to a continuous model (monitoring you every day). It empowers patients, informs surgeons, and ultimately drives better outcomes through accountability.

The future of the "Follow-up Clinic" is a dashboard, not a waiting room.

References

1. Correcta D, et al. "Accuracy of smart implants in TKA." Journal of Arthroplasty. 2023.
2. Purtill JJ. "Remote Patient Monitoring in Orthopedics." AAOS Now. 2021.
3. Appelboom G, et al. "Smart wearable body sensors for patient self-assessment and monitoring." Arch Public Health. 2014.