Educating patients on knee surgery with a medical app

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By: Matthew DiPaola, MD

The word “doctor” comes from the Latin “docere,” meaning “to teach.” Ancient civilizations clearly believed that the concepts of healing and patient education were tightly intertwined. Modern times have not altered this core principle. In fact, the increased complexity of medical knowledge probably makes it that much more important today.

Now, thanks to an expanding array of mobile apps, the doctor of today has a new host of wonderful tools with which to educate patients. Below I’ll tell you about a new one for knee problems.

Besides the occasional Norman Rockwell print, many surgeons’ exam rooms are decorated with the perfunctory anatomy poster. I am an orthopedic surgeon who specializes in shoulder and elbow surgery but I do a fair amount of general orthopedic surgery as well. So I often need to explain a variety of topics to my patients. In our practice we have a smattering of such posters, each with a different theme: knees, hands, shoulders. So, in addition to making (good?) wallpaper, the posters often help me illustrate basic anatomy to patients.

Predictably though, the patient with knee pain often winds up in the room with the shoulder poster and vice versa. Short of plastering the exam rooms with the the full complement of arm, leg and back anatomy posters, I have not had a solution to this problem…until now.

Orca MD has developed a series of anatomically precise mobile apps to aid the clinician who treats musculoskeletal conditions teach patients about relevant anatomy and pathology. We have previously reviewed their shoulder app (Shoulder Decide). Overall I think the KneeDecide app matches up equally as well and would work as a very useful aid in communicating basic knee anatomy and pathology to patients.

One immediate advantage of this iPad app is that the iPad is a nice sized device for this type of patient demonstration . When you enter the app you are presented with 3 tabs labeled: anatomy, condition and specialist. Clicking “anatomy” takes the user to a “virtual knee” illustration.

knee1

I liked the virtual knee. It was clear, bright and could rotate in 3 dimensions and bend. The illustrations are high quality, less “cartoonish” than others I have seen and they appear to be anatomically correct.

knee2

There is a small menu to the side labeled “control” which allows you to “layer” on ligaments and muscle to the bony structures. It is a good level of detail for a patient. The controls also allow you to add or subtract labels to the illustrations.

Click over to “condition” and you will see a nicely tiled layout of over a dozen various common knee pathologies: meniscus tear, arthritis, patellar tendonitis etc. Click one and you are taken to a screen which gives you an illustration of each pathology presented on the “virtual knee.” Again the illustrations are clear and anatomically accurate. I was, however, unable to zoom into the illustration for closer detail. In this layout you are also given the option of reviewing, arthroscopic pictures, MRIs, xrays and even short videos of the particular pathology. This is a very nice feature as many patients are curious what their problem looks like on the “inside.” A pulsing red dot directs your eye to the location of the pathology.

knee3

At the end of most of the photo series is usually a post operative xray or intra operative picture of the treatment. I like that it takes the patient from start to finish.

knee4

For each type of pathology, you have the option to email a link to a person of interest (likely a patient). I emailed a link to myself which worked and I was taken to a lesson on patella tendonitis. The information seemed accurate, and well laid out with a succinct summary of the problem and common treatments. On the Firefox browser this all came out nicely. I looked up the link on an older Explorer browser and the print for the summaries came out black on a blue background and was virtually impossible to read. This means that older browsers may not be fully compatible with the links generated and is something to be aware of.

The third tab was labeled “specialist.” Clicking on it allows the user to search for a given musculoskeletal practitioner: therapist, orthopedist, chiropractor.

knee5

If your mobile device is configured with a GPS locator then this app will help you find practitioners close to you which is a nice feature.

Likes:

  • Concise, simple layout
  • Clear accurate anatomical illustrations
  • Nice compilations of case examples from imaging to illustrations
  • Allows the user to compare normal images with the pathological conditions
  • Specialist locator feature

Dislikes:

  • Having the “locator app” as a separate free app might drive attention to the site and get more patients/ clinicians interested, not sure if this exists in this form yet
  • Including identifiers on the MRI images would be helpful, these are included on the illustrations but not the MRI’s which are confusing to even medical students and residents without training
  • The virtual knee pathology illustrations did not expand out, so smaller anatomical features are less likely to be appreciated

Overall:

  • A very good app
  • Would recommend it for any clinician that commonly treats knee conditions

Price:

  • $4.99

iTunes link

We are happy to welcome to our team Matthew DiPaola MD, a shoulder and elbow orthopedic surgeon at Wright State University. He will be contributing reviews on orthopedic and other medical apps. He has a long standing interest in medical technology and is also an avid blogger at MatthewDiPaolaMD.com.

Discussion ( 4 comments ) Post a Comment
  • As a Rheumatologist, I have bought all OrcaMD apps and have been using them on a semi-daily basis for patient education in the exam room on my iPad. I agree with the review.

    A few suggestions I emailed to OrcaMD was to add auto-inflammatory diseases such as RA, spondyloarthropathy, lupus, etc to the “conditions” section. I also agree with the need for pinch to zoom on many of the images.

    Overall though, I am quite pleased with their apps, and the price is very affordable (~$4 to $5).

  • Thank you to Dr Dipaola, iMedicalApps (Dr. Wodajo), & SiMBa37 (we read your tweet of last week and email. thank you).

    Your reviews and comments are very important to the refinement process of our apps. I’m certain that if you follow the ongoing development of KneeDecide and our other apps in the coming months, you’ll find that most (if not all) of your suggestions and critiques find their way into our apps.

  • Will this app ever come to android? Is there an equivalent for android?

    • not that we know of. unfortunately most companies work on iOS (apple) first for awhile before going to Android. this would be a great question to ask the developers of the app as well.

      Iltifat Husain, MD iMedicalApps Editor

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