San Diego, California-based DonJoy, a brand of the DJO Global, Inc. family, has launched the first knee brace for total knee arthroplasty that monitors patient recovery and compliance in real time. The product, the X4 Smart Brace with Motion Intelligence, is a cloud-based system.
DonJoy Launches First Real-Time Knee “Smart” Brace

According to the company, the X4 Smart Brace “…records patient data and transfers it from the patient app to the physician for review. X4 supports the knee while simultaneously allowing healthcare professionals to evaluate knee joint range of motion and rehabilitation compliance in real time.”
“X4 with Motion Intelligence is comprised of:
- X4 Smart Brace: Features a comfortable, anatomical design with malleable aluminum hinges for support and adaptability to different leg shapes.
- Motion Intelligence 360 Sensor (embedded in the X4 Knee Brace): Enables on-demand monitoring of patients’ rehabilitation progress (range of motion), as well as exercise and activity levels (daily step count).
- Motion Intelligence App: With the easy-to-use app, patients can track rehabilitation goals, view daily exercises, record pain levels, and communicate directly with healthcare providers.
- Physician Portal: Gives providers access to patient information via an intuitive dashboard that monitors and tracks patient information and integrates EMR/PM and surgical site photos.
All information is stored and sent in the HITRUST certified MotionMD platform, which means DJO meets and exceeds the highest requirements to create, access, store or exchange sensitive and/or regulated data.”
Kevin Brothen, DJO’s vice president of Marketing, Bracing and Supports, told OTW, “DJO is uniquely positioned to positively impact three key phases of the orthopedic care continuum and the X4 smart brace satisfies and supports the company’s position. The bracing, surgical and healthcare solutions teams worked cross-functionally to develop a product for our customers and patients that supports the market trends and enhances the dynamic communication between patients and physicians with the goal of better outcomes for all.”
“The X4 smart brace enhances the two-way communication between physicians and patients—physicians are now able to remotely track, monitor and communicate with patients from a distance, while patients have a direct line of communication with their provider and the confidence to stay motivated through rehab. The goal is better patient compliance and satisfaction.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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