What "Digital MSK Care" Means in Orthopedic Surgery

Digital MSK is one of those phrases that gets used constantly and defined rarely. For an orthopedic surgeon deciding whether any of it is worth attention, it helps to strip the term down to what it actually describes and what the evidence says.

What the term describes

Digital musculoskeletal care refers to using technology, apps, web platforms, home exercise programs, patient monitoring,  patient education, and outcomes collection to deliver or support care for musculoskeletal conditions outside the traditional in-person visit. It is a category—not a single product or device class—which is part of why the label is used so loosely. 

The common thread is extending care between visits through digital education, guided exercise, symptom tracking, and outcome measurement.

What the evidence actually shows

The research base is still maturing. 

A systematic review of digital health interventions for musculoskeletal conditions found meaningful reductions in pain and improvements in functional disability in a substantial share of studies, concluding these tools can deliver high-reach and low-cost scalable education and self-management. A later systematic review of digital exercise interventions reached similar conclusions for musculoskeletal disease, with the evidence graded as “moderate quality.”² 

Digital MSK approaches have been shown to help with pain, function, and self-management for many patients, and the strongest signal is in exercise and education rather than replacing surgical care.

Where it fits in orthopedic practice

For an orthopedic service, the practical value of digital MSK is in the surrounding care: preparing patients before surgery, guiding home exercise after it, monitoring non-adherent patients for complications, and collecting the outcomes that quality programs now demand. 

Digital MSK care is a way to extend a care team's reach without adding staff, particularly for patients who are geographically distant or between scheduled visits. It is not a substitute for surgical judgment, but rather a supplement that supports outcomes and prevents cost runaways. Plus, patients like the wraparound service, which means digital MSK care can be a big win at minimal cost.

A few words on monitoring

Orthopedic surgeons have access to a five-year-old monitoring CPT code set called remote therapeutic monitoring (RTM). RTM involves tracking whether a patient did their exercises, logged symptoms, or completed their education. It is behavioral, therapy-focused monitoring. RTM is not the physiologic, device-based capture of vital signs that defines remote physiologic monitoring (RPM), which sits under a different set of billing rules. 

Both are structured, between-visit feedback loops, but RTM has the benefit of not needing physical devices and allowing patient-reported data like outcomes and exercise feedback instead of physiologic indicators like heart rate or blood sugar. That’s right—RTM can be done with an app on your phone, meaning your patient can be set up in minutes instead of requiring a long training session with staff. 

In heart failure, where deterioration is silent until it becomes a crisis, physiologic monitoring has a mature evidence base: a meta-analysis of 41 trials and more than 16,000 patients found that remote monitoring was associated with lower mortality and a reduced risk of a first heart-failure hospitalization compared with usual care, and the landmark TIM-HF2 trial similarly reduced unplanned cardiovascular admissions and all-cause death. In COPD, the same pattern holds: telemonitoring reduces readmissions, ER visits, and mortality, chiefly in patients with a prior exacerbation history, cutting exacerbation-related readmissions (RR 0.74) and mortality (OR 0.71), whereas broad, unselected programs show little effect on hospitalizations and mainly reduce unnecessary ER visits rather than prevent admissions. Not every trial is positive, of course. A well-run heart-failure RCT that paired monitoring with financial incentives found no significant difference in readmission or death versus usual care. 

The overall theme across the literature is that monitoring works when it targets patients at genuine risk, when it targets patients who may be non-adherent, and when someone reviews and acts on the data.

The evidence for RTM in the orthopedic and MSK populations is less developed. A 2026 systematic review makes that point explicitly, noting that RTM collects subjective, patient-reported data and its evidence base remains developing and limited relative to RPM, but both the trial record and the most comprehensive independent synthesis point in the same direction. That synthesis is the Peterson Health Technology Institute's Virtual Musculoskeletal Solutions assessment, which evaluated eight virtual MSK interventions. PHTI concluded that the assessed solutions deliver clinically meaningful improvements in pain and function relative to usual care, that physical-therapist-guided programs match in-person therapy with a net decrease in spending, and that RTM-augmented care may deliver better clinical results on pain and functional improvement than in-person physical therapy alone. That verdict carries added weight because the same institute had, months earlier, found that digital diabetes-management tools produced no meaningful clinical benefit and raised spending.

The controlled trials fill in that picture. Patients enrolled in RTM alongside in-person PT participate more frequently in their plan of care, consistent with a broader telerehabilitation literature in which remote-supported programs prove to be at least as effective as in-person care and are associated with improved adherence and quality of life. After total knee arthroplasty, a randomized trial of digitally guided home rehabilitation improved functional outcomes, pain, and quality of life relative to conventional rehabilitation. And in chronic low back pain—the MSK condition with the most trial data—a head-to-head RCT found a remote digital program non-inferior to intensive in-person physiotherapy, with a markedly lower dropout rate (15.7 percent versus 34.3 percent). 

Adherence and retention are not soft endpoints in this setting. In a population where failure to complete rehabilitation is a leading driver of poor outcomes and avoidable surgery, keeping the patient engaged is the intervention. 

Get started with digital MSK and monitoring today! We can show you how!