September 1, 2008 Surgeons provide recent joint replacement patients with transmitters to wirelessly send blood pressure, pulse/oxygen, and breathing data to staff. Alarms alert staff to potential problems when patients roam away from their recovery rooms during physical therapy.
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Most patients who undergo joint replacement surgery need physical therapy to recover, a process that takes patients away from their bedside health monitors; but a new device is making it possible to safely monitor patients back to health.
Kelly Kirkbride considers it a miracle she's back on the job as an attorney.
"It was the standing, the stairs, just even walking from my car to the building was impossible," says Kirkbride.
For years, her knees hurt so badly she could barely function; the only remedy -- total knee replacement. Aging baby boomers like Kirkbride are putting joint replacement surgery on the rise.
Physical therapy helps get patients back on their feet sooner; but some exercise is risky for weak patients, and therapy units don't have monitors to warn staff of complications.
"In a unit where we're treating elderly patients, they're a little more frail; so the question arises as to how much can we let them do, how soon," says Vincent Pellegrini, M.D., an orthopaedic surgeon at University of Maryland Medical Center.
Now, a new wireless monitoring system allows hospital staff to check vital signs of on-the-move patients in hallways, private rooms or therapy units.
"It allows us to the get folks up and around as we typically do, but with an added margin of safety to know how their heart and lungs are responding to the exercise," Dr. Pellegrini says.
Patients carry around a small transmitter linked to a blood pressure cuff and pulse meter. Wireless signals carry vital-sign data to screens throughout the unit. An alarm alerts staff of irregular breathing, heart beat or pulse, and erratic blood pressure. The system will help define exercise guidelines for physical therapy units, while keeping a watchful eye on patients.
The number of joint replacement cases, especially for knee and hip replacements, is expected to increase dramatically in the next 25 years. Researchers hope to improve this technology to elevate the standard of care for all patients.
MOBILE MONITORING SYSTEM: Patients at the University of Maryland's Medical Center's inpatient orthopedics unit are given hardware that allows staff to monitor their progress at all times of day and night. Blood pressure cuffs and pulse/oxygen meters are connected to a transmitter carried in a pouch. Constant monitoring makes physical therapy safer and allows patients to exercise safely, to promote a quick recovery. Any irregularities in monitored readings trigger alarms to alert staff.
WHEN GOOD JOINTS GO BAD: A healthy knee bends easily, absorbs stress and glides smoothly so that we can walk, squat, or turn without pain. When the knee is damaged, it is less able to handle stress, causing pain and swelling. Injuries to the ACL are the most common. Often there is a loud "pop" -- the sound of the ligament tearing --followed by pain and immediate swelling. After those symptoms subside, the patient may still experience episodes of instability, often likened to walking on roller skates. The knee may feel loose. In serious cases, surgical repair may be required.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

