Study to evaluate virtual rehabilitation platform after knee replacement

Dec. 21, 2016

San Diego, CA. Reflexion Health Inc., a digital healthcare company, in conjunction with the Duke Clinical Research Institute (DCRI), announced the enrollment of the first patients in Virtual Exercise Rehabilitation In-home Therapy: A Research Study (VERITAS), which is designed to evaluate the cost and outcomes of using a virtual rehabilitation platform to deliver physical therapy following total knee replacement (TKR) surgery.

According to the Centers for Disease Control and Prevention, 700,000 total knee replacements are performed each year in the United States. TKR is the most frequently performed procedure in the hospital and is more common among women than men.1 The average Medicare expenditure for surgery, hospitalization, and recovery ranges from $16,500 to $33,000 across geographic areas.2 With a significant growth in TKR among younger adults with knee osteoporosis,3 an aging population working longer, and a shift to value-based care, the demand for TKR surgery is expected to exceed three million by the year 2030 while at the same time, healthcare systems will continue to optimize costs.

“Physical therapy is often a critical component of care for patients who have TKR surgery. Digital health technology, including virtual and telehealth options, may increase access, improve quality, and lower healthcare costs,” said Janet Prvu Bettger, ScD, associate professor with the Duke Department of Orthopaedic Surgery and principal investigator for the study at the DCRI. “Extending the reach of physical therapists into the home using a digital healthcare platform like VERA can provide remote guidance and supervision for a home-based therapy program; however, implementation in the U.S. has not been widely evaluated until now.”

VERITAS is a multi-center, randomized controlled trial and will enroll approximately 300 adult participants scheduled for TKR surgery at six U.S. sites. The treatment group will include 150 adults who will receive Reflexion Health’s proprietary virtual exercise rehabilitation assistant, VERA, both pre- and post-surgery, compared with a control group of 150 adults who will receive traditional in-home or clinic-based physical therapy at participating sites. Clinical outcomes, health service use, and costs will be examined for three months after surgery.

With VERITAS, we are eager to con?rm what we’ve already demonstrated with hospitals and clinicians in pilot studies—VERA is a cost-effective, scalable, and effective option for improving compliance and recovery in home-based physical therapy following total knee replacement surgery,” said Joseph (Joe) Smith, MD, PhD, president and CEO of Reflexion Health. “VERA embodies our commitment to delivering solutions that improve the patient experience by saving time, travel, and costs for both patients and healthcare systems.”


  1. Williams, S.N., Wolford, M.L., Bercovitz, A., “Hospitalization for total knee replacement among inpatients aged 45 and over: United States, 2000–2010,” NCHS data brief, no 210. Hyattsville, MD, National Center for Health Statistics. 2015.
  2. “Comprehensive Care for Joint Replacement Model,” CMS, 2016,

3. Weinstein, A.M., Rome, B.N., Reichmann, W.M., et al., “Estimating the Burden of Total Knee Replacement in the United States,” The Journal of Bone and Joint Surgery American, 2013.

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