Interventions
DISEASES
Both recruiting medical centers are certified endoprosthesis centers of maximum care (EPZmax, EndoCert GmbH, Berlin, Germany). In total, eight experienced orthopaedic surgeons were involved in this study and for each surgery, one of the EndoCert certified surgeons was present. After surgery and inpatient care in the hospital, all participants (IG and CG) underwent three to four weeks of standard inpatient or outpatient rehabilitation. Afterwards, the IG received outpatient therapy twice a week until the sixth postoperative month. During this period, the participants received standardized group therapy with the video-based rehabilitation tool YOLii (E + S Gesunde Lösungen GmbH, Hamburg, Germany), which was supervised by a physiotherapist. Every participant had a personalized login to the YOLii system. Based on the ICD-10 codes (International Statistical Classification of Diseases and Related Health Problems), a pre-selection of exercises was suggested to the physiotherapist, which was then individually adapted to the patient’s needs. This allows supervision of up to five patients simultaneously by one therapist. Six warm-up exercises, 24 main exercises, and four stretching exercises were selected in the YOLii system based on the recommendations of the American Academy of Orthopaedic Surgeons as well as the recommendations of Vancouver General Hospital and Richmond Hospital [YOLii monitor showing exercise instruction and explanatory videoParticipants in the CG continued individual outpatient therapy after the three to four weeks standard rehabilitation depending on the prescription of the supervising physician. The number of therapy sessions for both groups was inquired at the six-months follow-up. Nevertheless, the duration of each session was not considered due to the variety of therapy approaches with different therapy durations depending on the doctor's prescription. As the novel digital-assisted group therapy concept is not yet supported by the German health insurance, we were not able to report the costs for both therapy approaches.