April 14, 2026
1 min read
Key takeaways:
- Deep infection was indicated by a decline in step count and walking speed.
- Need for antibiotics was indicated by a decline in step count and knee range of motion.
NEW ORLEANS — Use of a sensor-enabled smart device implanted at the time of total knee arthroplasty may detect periprosthetic joint infection before diagnosis, according to results presented here.
“By monitoring patients’ recovery with a smart device, we noticed a change in three parameters: the range of motion, steps and walking speeds,” Fred D. Cushner, MD, from Hospital for Special Surgery, told Healio. “When range of motion, steps and walking speeds are at a certain level and suddenly go down, patients need to be examined for possible infection.”
Use of a sensor-enabled smart device implanted at the time of total knee arthroplasty may detect periprosthetic joint infection before diagnosis. Image: Adobe Stock
Cushner and colleagues retrospectively reviewed data from 6,394 patients who received a sensor-enabled smart implantable device during TKA between October 2021 and January 2025.
Fred D. Cushner
“We had 17 patients with deep infections and 16 of them were treated with antibiotics, so we assume those were superficial infections,” Cushner said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
According to the abstract, researchers calculated 3-day moving averages for step count, walking speed, cadence and functional knee range of motion from 2 weeks before to 2 weeks after diagnosis of PJI. Researchers also assessed percentage changes from baseline to days 7, 3 and 1 prediagnosis, the day of PJI diagnosis and days 1, 3 and 7 postdiagnosis.
According to Cushner, patients had a meaningful decline in step count, walking speed and range of motion before diagnosis of deep infection, while patients who were taking antibiotics had a significant decline in step count.
“One of the things about arthroplasty infections is the earlier you catch it, the better it gets,” Cushner told Healio. “If you catch it late, then everything has to come out and we can debate whether to do a one-stage or two-stage, but still it is a big operation. If you catch it early then the [debridement, antibiotics and implant retention (DAIR)] procedure is much more effective. These were markers to detect infection early that we picked up by examining a dataset.”
For more information:
Fred D. Cushner, MD, wishes to be contacted through Monica Kendrick at mkendrick@canarymedical.com.
Sources/Disclosures
Source:
Sinclair MW, et al. Paper 386. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 2-6, 2026; New Orleans.
Disclosures:
Cushner reports being a consultant for and a founder and stockholder of Canary Medical.
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