By Dr. Andrew Wickline, CMO, Kinomatic
Joint replacement surgery helps give over a million people their lives back each year. When it goes well, patients return to walking, to their families, to the things that matter to them. I’ve spent 24 years and more than 16,000 procedures trying to make that the consistent outcome, not the lucky one.
What I’ve found is that the gap between what’s possible and what most patients actually experience is wider than most people realize, and that gap is closable. That’s why I joined Kinomatic as Chief Medical Officer.
An Outcome Gap Worth Closing
Over the last decade, the field has made meaningful progress in joint replacement. Implant technology has improved. Surgical precision has advanced. And yet some patient outcome metrics have been slower to follow.
Consider a few numbers that deserve more attention:
- 1 in 11 total joint patients develop an opioid dependence following surgery.1 That’s 144,000 Americans per year, and it’s a number we have evidence-based tools to address.
- 45% of total knee patients still haven’t achieved 110 degrees of flexion four months post-operatively, even with regular physical therapy.2 That’s 450,000 people who can’t perform basic daily movements months after their procedure.
- Persistent muscle weakness at two years remains common3, despite the fact that targeted nutritional and recovery protocols have been shown to prevent it.
These aren’t indictments of anyone. They reflect a system where the science has often moved faster than the infrastructure to deliver it consistently. Surgeons are highly skilled but they’re operating in practices where post-operative recovery support is frequently fragmented, underfunded, or absent.
That’s the opportunity. And it’s a significant one.
What the Research Showed
In 2015, I started asking a question that felt almost too simple: do my patients actually need opioids to recover well from joint replacement?
The answer, after more than a decade of clinical work and roughly twelve published papers, is no, at least not in the way they’re typically prescribed. In 2020 I published research demonstrating that 97% of my patients required 10 opioid pills or less, with the average being 3.5 pills per patient in the six weeks following surgery.4 My patients routinely achieve full range of motion at two weeks that the average patient doesn’t reach at four months. And I haven’t written a routine opioid prescription in years.
What made the difference wasn’t a single intervention. It was over 40 protocol decisions (pre-operative patient education, surgical technique choices, compression and cold therapy, targeted nutrition, and structured recovery support), each backed by published evidence, each compounding on the others.
My why, through all of it, has been consistent: I don’t want a single one of my patients to face a preventable outcome. Not pain that didn’t need to happen. Not a dependency that started with a prescription. Not a recovery that stalled because the right support wasn’t there.
What Patients Deserve
The vision for this work is straightforward: help empower patients to get the outcome they want. That means patients who are educated, supported, and clear on what they can do to optimize their recovery.
Patients come into surgery with real concerns: whether the pain will be managed, whether the procedure will actually solve the problem, how long recovery will take, when they’ll be back to their kids and their lives. Addressing those concerns proactively, before the procedure, changes how patients show up for their recovery.
The evidence is clear that education needs to include both the recommendation and the rationale. When patients understand why a protocol step matters and what happens if they skip it, compliance improves. Preparation six weeks before surgery changes outcomes at six months post-op.
Education alone isn’t enough, though. Patients also need human support. Someone they feel is on their team, available, consistent, and invested in their progress. That combination of informed preparation and ongoing navigation is what produces reliable results.
And even when a patient is in a system that hasn’t yet fully adopted opioid-sparing protocols, they should still have the tools to take ownership of their recovery.
Why Kinomatic
I approached Kinomatic the way I approach most clinical questions: with skepticism and an interest in the evidence.
I’m a pilot and a car racer. In both, I rely on simulators because practicing the maneuver before it counts is how you perform well when it does. When I started using Kinomatic for pre-operative planning, I found that the majority of those patients outperformed my already strong baseline. For a surgeon who’s spent 24 years trying to optimize every variable, a measurable improvement is meaningful.
But the platform is only part of what brought me here. What Kinomatic has built (a surgeon network, operational rigor, and dedicated Patient Navigators to support patients 1:1) maps directly to the protocol I’ve spent more than a decade refining. It’s the infrastructure that translates what one practice has proven into something a practice or patient anywhere in the country can access.
There’s a real opportunity to deliver a first-class recovery experience for patients who want it. Kinomatic has the platform, the people, and the infrastructure to make that possible at scale. This partnership is what turns one practice’s outcomes into a national standard.
March 2 A Million
I built March 2 A Million with the mission of helping one million patients recover from knee and hip replacement surgery with little to no opioids.
We’re at 3,000 patients on the leaderboard today, with more than 50 surgeons already applying elements of this protocol. The target is 10,000 patients by year’s end. The mission isn’t about any one practice. It’s about making the best available recovery science accessible to every patient and every surgeon who wants it.
What’s Next
There’s more coming soon. Kinomatic and I are building something that brings together precision surgical planning and a recovery experience designed to perform, combining tools, navigation, accountability, and outcomes tracking for both surgeons and patients.
It’s built to close the gap between a successful surgery and a successful life after it.
The science exists. The protocols are proven. The platform is here. The work now is making sure every patient who needs this can access it.
If you’re a surgeon or patient who’s curious about opioid-sparing protocols, fill out the form below to connect with us today.
Dr. Andrew Wickline is a board-certified orthopedic surgeon with 24 years in practice, 16,000+ joint replacements performed, and the author of 12+ peer-reviewed publications on post-operative recovery optimization. He serves as Chief Medical Officer at Kinomatic and co-stewards March 2 A Million.