Intelligent cloud platform follow-up model improves joint range of motion and reduces follow-up costs after total knee arthroplasty: A retrospective cohort study

YU Shangwei; ZENG Ke; XIONG Ran; LIU Liming; GUO Lin

doi:10.16016/j.2097-0927.202508049

您当前的位置：

首页 >

文章列表页 >

Intelligent cloud platform follow-up model improves joint range of motion and reduces follow-up costs after total knee arthroplasty: A retrospective cohort study

Clinical Medicine | 更新时间：2025-11-28

- Intelligent cloud platform follow-up model improves joint range of motion and reduces follow-up costs after total knee arthroplasty: A retrospective cohort study
- Journal of Army Medical University Vol. 47, Issue 22, Pages: 2763-2773(2025)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）第一附属医院：，运动医学中心，（第三军医大学）第一附属医院江北院区（陆军军第九五八医院）骨科，重庆
  2.陆军军医大学（第三军医大学）第一附属医院：，关节外科中心，（第三军医大学）第一附属医院江北院区（陆军军第九五八医院）骨科，重庆
  3.陆军军医大学（第三军医大学）第一附属医院：，陆军军医大学，（第三军医大学）第一附属医院江北院区（陆军军第九五八医院）骨科，重庆
  4.Hospital of PLA Army, Chongqing， China
- 作者简介：
  
  LIU Liming， E-mail： 307547149@qq.com
  GUO Lin， E-mail： guolin6212@163.com
- 基金信息：
  
  the National Key Research and Development Program(2021YFC2401304)
- DOI：10.16016/j.2097-0927.202508049
  CLC： R195.4;R473.6;R687.4
- Received：18 August 2025，
  
  Revised：2025-11-13，
  
  Accepted：14 November 2025，
  
  Published：30 November 2025
- 稿件说明：
移动端阅览
余尚委，曾科，熊然，等.智能云平台随访模式可改善全膝关节置换术后关节活动度并降低随访成本：一项回顾性队列研究［J］.陆军军医大学学报，2025，47（22）：2763-2773.DOI：10.16016/j.2097-0927.202508049.

YU S W，ZENG K，XIONG R，et al.Intelligent cloud platform follow-up model improves joint range of motion and reduces follow-up costs after total knee arthroplasty： A retrospective cohort study［J］.J Army Med Univ，2025，47（22）：2763-2773.DOI：10.16016/j.2097-0927.202508049.
余尚委，曾科，熊然，等.智能云平台随访模式可改善全膝关节置换术后关节活动度并降低随访成本：一项回顾性队列研究［J］.陆军军医大学学报，2025，47（22）：2763-2773.DOI：10.16016/j.2097-0927.202508049. DOI：

YU S W，ZENG K，XIONG R，et al.Intelligent cloud platform follow-up model improves joint range of motion and reduces follow-up costs after total knee arthroplasty： A retrospective cohort study［J］.J Army Med Univ，2025，47（22）：2763-2773.DOI：10.16016/j.2097-0927.202508049. DOI：

摘要

目的

探究基于智能云平台的随访模式在全膝关节置换术（total knee arthroplasty， TKA）后随访质量、随访成本及膝关节功能恢复上较传统随访模式是否具备优势。

方法

回顾性收集2022年10月至2023年9月于陆军军医大学第一附属医院行TKA的患者资料260例，根据术后不同随访方式分为云平台组（130例）与传统组（130例），收集并比较2组患者的基线资料、手术前后膝关节功能评分及随访成本。

结果

云平台组的随访满意率高于传统组（

0.05），且其单次随访时间、单次陪同人数、总随访花费和总随访时间均显著低于传统组（

0.05）。术后6周、3月、6月、12月，云平台组的关节活动度（range of motion， ROM）均优于传统组（

0.05），2组间的其他膝关节功能评分差异无统计学意义。

结论

基于云平台随访模式在术后早期（6周至12个月）膝关节ROM方面优于传统随访模式，且具备低随访成本优势，可作为TKA术后随访的有效替代方案。

Abstract

Objective

To determine whether an intelligerct cloud platform follow-up model demonstrates superiority over conventional methods in enhancing follow-up quality

reducing costs

and improving functional recovery following total knee arthroplasty(TKA).

Methods

A retrospective cohort study was conducted on 260 patients undergoing TKA at our hospital from October 2022 to September 2023. According to the different postoperative follow-up methods

they were divided int a cloud platform group (

=130) and a traditional group (

=130). The baseline data

pre- and postoperative knee function scores

and follow-up costs were collected and compared between the 2 groups.

Results

The cloud platform group exhibited significantly higher rate of follow-up satisfaction

reduced resource utilization

shorter per-follow-up duration

fewer accompanying persons per visit

lower total follow-up expenditures

and decreased cumulative follow-up time when compared with the traditional group (

0.05). At 6 weeks

and 12 months postoperatively

better range of motion (ROM) was observed in the cloud-based group than the traditional group (

0.05)

but no intergroup differences were seen in other knee function scores.

Conclusion

Cloud platform follow-up enhances early postoperative ROM (6 weeks to 12 months) and demonstrates marked cost-effectiveness when compared to the conventional mode. It represents a viable alternative for post-TKA rehabilitation surveillance.

关键词

Keywords

references

MOFFET H ， TOUSIGNANT M ， NADEAU S ， et al . In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty： a noninferiority randomized controlled trial ［J］. J Bone Joint Surg Am ， 2015 ， 97 （ 14 ）： 1129 - 1141 . DOI： 10.2106/JBJS.N.01066 http://dx.doi.org/10.2106/JBJS.N.01066 .

HUNG A ， LI Y ， KEEFE F J ， et al . Ninety-day and one-year healthcare utilization and costs after knee arthroplasty ［J］. Osteoarthritis Cartilage ， 2019 ， 27 （ 10 ）： 1462 - 1469 . DOI： 10.1016/j.joca.2019.05.019 http://dx.doi.org/10.1016/j.joca.2019.05.019 .

LONNER J H ， NAIDU-HELM A ， VAN ANDEL D ， et al . Smartphone-based care platform versus traditional care in primary knee arthroplasty in the unites states： cost analysis ［J］. JMIR Mhealth Uhealth ， 2025 ， 13 ： e46047 . DOI： 10.2196/46047 http://dx.doi.org/10.2196/46047 .

CORREIA F D ， NOGUEIRA A ， MAGALHÃES I ， et al . Medium-term outcomes of digital versus conventional home-based rehabilitation after total knee arthroplasty： prospective， parallel-group feasibility study ［J］. JMIR Rehabil Assist Technol ， 2019 ， 6 （ 1 ）： e13111 . DOI： 10.2196/13111 http://dx.doi.org/10.2196/13111 .

WU C H ， CHIU R K ， YEH H M ， et al . Implementation of a cloud-based electronic medical record exchange system in compliance with the integrating healthcare enterprise’s cross-enterprise document sharing integration profile ［J］. Int J Med Inform ， 2017 ， 107 ： 30 - 39 . DOI： 10.1016/j.ijmedinf.2017. 09.001 http://dx.doi.org/10.1016/j.ijmedinf.2017.09.001 .

DUMENCI L ， PERERA R A ， KEEFE F J ， et al . Model-based pain and function outcome trajectory types for patients undergoing knee arthroplasty： a secondary analysis from a randomized clinical trial ［J］. Osteoarthritis Cartilage ， 2019 ， 27 （ 6 ）： 878 - 884 . DOI： 10.1016/j.joca.2019.01.004 http://dx.doi.org/10.1016/j.joca.2019.01.004 .

WANG Y E ， KUTNETSOV L ， PARTENSKY A ， et al . WebMeV： a cloud platform for analyzing and visualizing cancer genomic data ［J］. Cancer Res ， 2017 ， 77 （ 21 ）： e11 - e14 . DOI： 10.1158/0008-5472.CAN-17-0802 http://dx.doi.org/10.1158/0008-5472.CAN-17-0802 .

COTTRELL M A ， GALEA O A ， O’LEARY S P ， et al . Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice： a systematic review and meta-analysis ［J］. Clin Rehabil ， 2017 ， 31 （ 5 ）： 625 - 638 . DOI： 10.1177/0269215516645148 http://dx.doi.org/10.1177/0269215516645148 .

BELL K ， WARNICK E ， NICHOLSON K ， et al . Patient adoption and utilization of a web-based and mobile-based portal for collecting outcomes after elective orthopedic surgery ［J］. Am J Med Qual ， 2018 ， 33 （ 6 ）： 649 - 656 . DOI： 10.1177/1062860618765083 http://dx.doi.org/10.1177/1062860618765083 .

刘力铭，雷凯，熊然，等 . 股骨远端外翻截骨角在精准全膝关节置换术中的作用研究进展［J］. 中华创伤杂志， 2022 ， 38 （ 11 ）： 1048 - 1056 . DOI： 10.3760/cma.j.cn501098-20220510-00367 http://dx.doi.org/10.3760/cma.j.cn501098-20220510-00367 .

LIU L M ， LEI K ， XIONG R ， et al . Research progress on the role of Valgus osteotomy angle of distal femur in precise total knee arthroplasty ［J］. Chin J Trauma ， 2022 ， 38 （ 11 ）： 1048 - 1056 . DOI： 10.3760/cma.j.cn501098-20220510-00367 http://dx.doi.org/10.3760/cma.j.cn501098-20220510-00367 .

雷凯，刘力铭，范华全，等 . 全膝关节置换术中3种股骨旋转截骨参考轴线的准确度对比［J］. 第三军医大学学报， 2021 ， 43 （ 3 ）： 261 - 266 . DOI： 10.16016/j.1000-5404.202008174 http://dx.doi.org/10.16016/j.1000-5404.202008174 .

LEI K ， LIU L M ， FAN H Q ， et al . Accuracy of 3 reference axes for femoral rotation in total knee arthroplasty： a comparative study of 124 cases ［J］. J Third Mil Med Univ ， 2021 ， 43 （ 3 ）： 261 - 266 . DOI： 10.16016/j.1000-5404.202008174 http://dx.doi.org/10.16016/j.1000-5404.202008174 .

LEI K ， LIU L M ， XIANG Y ， et al . Clinical value of CT-based patient-specific 3D preoperative design combined with conventional instruments in primary total knee arthroplasty： a propensity score-matched analysis ［J］. J Orthop Surg Res ， 2020 ， 15 （ 1 ）： 591 . DOI： 10.1186/s13018-020-02123-5 http://dx.doi.org/10.1186/s13018-020-02123-5 .

KO V ， NAYLOR J ， HARRIS I ， et al . One-to-one therapy is not superior to group or home-based therapy after total knee arthroplasty： a randomized， superiority trial ［J］. J Bone Jt Surg ， 2013 ， 95 （ 21 ）： 1942 - 1949 . DOI： 10.2106/jbjs.l.00964 http://dx.doi.org/10.2106/jbjs.l.00964 .

CORREIA F D ， NOGUEIRA A ， MAGALHÃES I ， et al . Home-based rehabilitation with a novel digital biofeedback system versus conventional in-person rehabilitation after total knee replacement： a feasibility study ［J］. Sci Rep ， 2018 ， 8 （ 1 ）： 11299 . DOI： 10.1038/s41598-018-29668-0 http://dx.doi.org/10.1038/s41598-018-29668-0 .

CRAWFORD D A ， DUWELIUS P J ， SNELLER M A ， et al . 2021 Mark Coventry Award： Use of a smartphone-based care platform after primary partial and total knee arthroplasty： a prospective randomized controlled trial ［J］. Bone Joint J ， 2021 ， 103-B（6 Supple A）： 3 - 12 . DOI： 10.1302/0301-620X.103B6.BJJ-2020-2352.R1 http://dx.doi.org/10.1302/0301-620X.103B6.BJJ-2020-2352.R1 .

NUEVO M ， RODRÍGUEZ-RODRÍGUEZ D ， JAUREGUI R ， et al . Telerehabilitation following fast-track total knee arthroplasty is effective and safe： a randomized controlled trial with the ReHub ® platform ［J］. Disabil Rehabil ， 2024 ， 46 （ 12 ）： 2629 - 2639 . DOI： 10.1080/09638288. 2023. 2228689 http://dx.doi.org/10.1080/09638288.2023.2228689 .

WANG Q L ， HUNTER S ， LEE R L ， et al . The effectiveness of a mobile application-based programme for rehabilitation after total hip or knee arthroplasty： a randomised controlled trial ［J］. Int J Nurs Stud ， 2023 ， 140 ： 104455 . DOI： 10.1016/j.ijnurstu.2023.104455 http://dx.doi.org/10.1016/j.ijnurstu.2023.104455 .

BRADBURY T L ， MCCONNELL M J ， WHITACRE D ， et al . A remote physical therapy program demonstrates similar outcomes compared to in-person， supervised physical therapy after same-day discharge total knee arthroplasty： a randomized clinical trial ［J］. J Arthroplasty ， 2024 ， 39 （ 11 ）： 2725 - 2730.e4 . DOI： 10.1016/j.arth.2024.05.040 http://dx.doi.org/10.1016/j.arth.2024.05.040 .

CHRISTIANSEN C L ， KLINE P W ， ANDERSON C B ， et al . Optimizing total knee arthroplasty rehabilitation with telehealth physical activity behavior change intervention： a randomized clinical trial ［J］. Phys Ther ， 2024 ， 104 （ 10 ）： pzae088 . DOI： 10.1093/ptj/pzae088 http://dx.doi.org/10.1093/ptj/pzae088 .

张鑫，陆妍婷，张弛，等 . 全髋置换术后远程居家康复和住院康复疗效比较［J］. 同济大学学报（医学版）， 2024 ， 45 （ 1 ）： 57 - 65 . DOI： 10.12289/j.issn.1008-0392.23151 http://dx.doi.org/10.12289/j.issn.1008-0392.23151 .

ZHANG X ， LU Y T ， ZHANG C ， et al . Comparison between home-based tele-rehabilitation and in-hospital rehabilitation for total hip arthroplasty patients ［J］. J Tongji Univ Med Sci ， 2024 ， 45 （ 1 ）： 57 - 65 . DOI： 10.12289/j.issn.1008-0392.23151 http://dx.doi.org/10.12289/j.issn.1008-0392.23151 .

KARIMIJASHNI M ， YOO S ， BARNES K ， et al . Postoperative rehabilitation interventions in patients at risk of poorer outcomes following total knee arthroplasty： a systematic review ［J］. Musculoskeletal Care ， 2025 ， 23 （ 1 ）： e70054 . DOI： 10.1002/msc.70054 http://dx.doi.org/10.1002/msc.70054 .

SUN K B ， WU Y G ， WU L M ， et al . Comparison of clinical outcomes among total knee arthroplasties using posterior-stabilized， cruciate-retaining， bi-cruciate substituting， bi-cruciate retaining designs： a systematic review and network meta-analysis ［J］. Chin Med J ， 2023 ， 136 （ 15 ）： 1817 - 1831 . DOI： 10.1097/CM9.0000000000002183 http://dx.doi.org/10.1097/CM9.0000000000002183 .

ALEXANDER J S ， REDFERN R E ， DUWELIUS P J ， et al . Use of a smartphone-based care platform after primary partial and total knee arthroplasty： 1-year follow-up of a prospective randomized controlled trial ［J］. J Arthroplasty ， 2023 ， 38 （7 Suppl 2 ）： S208 - S214 . DOI： 10.1016/j.arth. 2023.02.082 http://dx.doi.org/10.1016/j.arth.2023.02.082 .

BUHAGIAR M A ， NAYLOR J M ， HARRIS I A ， et al . Assessment of outcomes of inpatient or clinic-based vs home-based rehabilitation after total knee arthroplasty： a systematic review and meta-analysis ［J］. JAMA Netw Open ， 2019 ， 2 （ 4 ）： e192810 . DOI： 10.1001/jamanetworkopen. 2019.2810 http://dx.doi.org/10.1001/jamanetworkopen.2019.2810 .

HENRY J P ， TAMER P ， SCUDERI G R . Internet-based patient portals increase patient connectivity following total knee arthroplasty ［J］. J Knee Surg ， 2025 ， 38 （ 8 ）： 386 - 392 . DOI： 10.1055/a-2542-7427 http://dx.doi.org/10.1055/a-2542-7427 .

ZHANG X Z ， CHEN X X ， KOURKOUMELIS N ， et al . A social media-promoted educational community of joint replacement patients using the WeChat app： survey study ［J］. JMIR Mhealth Uhealth ， 2021 ， 9 （ 3 ）： e18763 . DOI： 10.2196/18763 http://dx.doi.org/10.2196/18763 .

ZACHWIEJA E ， THEOSMY E G ， YACOVELLI S J ， et al . Web-based self-directed exercise program is cost-effective compared to formal physical therapy after primary total knee arthroplasty ［J］. J Arthroplasty ， 2020 ， 35 （ 9 ）： 2335 - 2341 . DOI： 10.1016/j.arth.2020.04.061 http://dx.doi.org/10.1016/j.arth.2020.04.061 .

PRVU BETTGER J ， GREEN C L ， HOLMES D N ， et al . Effects of virtual exercise rehabilitation in-home therapy compared with traditional care after total knee arthroplasty： VERITAS， a randomized controlled trial ［J］. J Bone Joint Surg Am ， 2020 ， 102 （ 2 ）： 101 - 109 . DOI： 10.2106/JBJS.19.00695 http://dx.doi.org/10.2106/JBJS.19.00695 .

ALJUHANI W S ， ALJAIAN A R ， ALYAHYA Y K ， et al . Timing and risk factors of complications following total knee arthroplasty ［J］. Ann Med Surg ， 2024 ， 86 （ 12 ）： 6968 - 6975 . DOI： 10.1097/MS9.0000000000002715 http://dx.doi.org/10.1097/MS9.0000000000002715 .

HINTERWIMMER F ， LAZIC I ， LANGER S ， et al . Prediction of complications and surgery duration in primary TKA with high accuracy using machine learning with arthroplasty-specific data ［J］. Knee Surg Sports Traumatol Arthrosc ， 2023 ， 31 （ 4 ）： 1323 - 1333 . DOI： 10.1007/s00167-022-06957-w http://dx.doi.org/10.1007/s00167-022-06957-w .

SIBIA U S ， MANDELBLATT A E ， CALLANAN M A ， et al . Incidence， risk factors， and costs for hospital returns after total joint arthroplasties ［J］. J Arthroplasty ， 2017 ， 32 （ 2 ）： 381 - 385 . DOI： 10.1016/j.arth.2016.08.003 http://dx.doi.org/10.1016/j.arth.2016.08.003 .

曾秋芬，陈妙芬，李素玲，等 . 回授法联合云平台随访系统在人工全膝关节置换术患者的应用效果［J］. 福建医药杂志， 2023 ， 45 （ 3 ）： 162 - 164 . DOI： 10.3969/j.issn.1002-2600.2023.03.060 http://dx.doi.org/10.3969/j.issn.1002-2600.2023.03.060 .

ZENG Q F ， CHEN M F ， LI S L ， et al . Application effect of teach-back method combined with cloud platform follow-up system in patients undergoing total knee arthroplasty ［J］. Fujian Med J ， 2023 ， 45 （ 3 ）： 162 - 164 . DOI： 10.3969/j.issn.1002-2600.2023.03.060 http://dx.doi.org/10.3969/j.issn.1002-2600.2023.03.060 .

DAMERY S ， JONES J ， O’CONNELL FRANCISCHETTO E ， et al . Remote consultations versus standard face-to-face appointments for liver transplant patients in routine hospital care： feasibility randomized controlled trial of myVideoClinic ［J］. J Med Internet Res ， 2021 ， 23 （ 9 ）： e19232 . DOI： 10.2196/19232 http://dx.doi.org/10.2196/19232 .

CHEN Z J ， LIANG W T ， LIU Q ， et al . Use of a remote oncology pharmacy service platform for patients with cancer during the COVID-19 pandemic： implementation and user acceptance evaluation ［J］. J Med Internet Res ， 2021 ， 23 （ 1 ）： e24619 . DOI： 10.2196/24619 http://dx.doi.org/10.2196/24619 .

SALARI R ， R NIAKAN KALHORI S ， GHAZISAEEDI M ， et al . Mobile-based and cloud-based system for self-management of people with type 2 diabetes： development and usability evaluation ［J］. J Med Internet Res ， 2021 ， 23 （ 6 ）： e18167 . DOI： 10.2196/18167 http://dx.doi.org/10.2196/18167 .

MCLEAN K A ， SGRÒ A ， BROWN L R ， et al . Evaluation of remote digital postoperative wound monitoring in routine surgical practice .［J］. NPJ Digital Medicine ， 2023 ， 6 （ 1 ）： 85 . DOI： 10.1038/s41746-023-00824-9 http://dx.doi.org/10.1038/s41746-023-00824-9 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Short-term efficacy and learning curve of robot-assisted total knee arthroplasty

Protective effect of parathyroid hormone (1-34) against early osteoarthritis in mice with type 1 diabetes mellitus

Establishment of animal models of bilateral knee joint osteoarthritis by arthroscopy

Study on biological characteristics of subchondral bone osteoblasts in osteoarthritis patients

Related Author

YU Huan

WANG Jiating

WANG Xiaowen

WANG Siyue

WANG Mengying

WU Tao

WU Yao

WANG Zijing

Related Institution

北京大学护理学院

北京大学公共卫生学院流行病与卫生统计学系

Chongqing Key Laboratory of Precision Medicine of Joint Surgery, Center for Joint Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University)

Department of Emergency Medicine, Second Affiliated Hospital, Army Medical University (Third Military Medical University)

Department of Combat Casualty Care Training, Army Training Base for Health Care, Army Medical University (Third Military Medical University)

⁰