Total joint replacement surgery has never been more precise. So why does recovery still feel like the part nobody prepared you for? We sat down with Dr. Naha Pandya to talk about RESTORE, our new pilot recovery program launching this summer at three orthopedic practices. Dr. Pandya spent over a decade treating joint replacement patients as a physical therapist before joining Kinomatic to help build RESTORE from the ground up.
For someone who’s never heard of Kinomatic RESTORE, how would you describe it?
In plain language, RESTORE is an end-to-end program for patients undergoing total hip or knee replacement surgery.
Here’s the way most people experience joint replacement today: you see a surgeon, you schedule surgery, you have the surgery, you get handed a prescription for pain medication along with an order for physical therapy, and then you’re sent home to figure out the rest on your own.
RESTORE replaces that with an actual system and guided support. It includes a customized pre-operative surgical plan, ongoing recovery support, and a recovery bundle designed to reduce swelling, pain, and reliance on opioids. That includes essential amino acids, a cryo-compression device, a wearable device, and educational materials, including a recovery guide and workbook. But the part most people underestimate is the simplest one: a real person checking in on you the whole way.
What is RESTORE based on?
It comes from a simple question we ask in healthcare a lot: what’s actually still broken? And the answer isn’t surgery. Surgery itself is excellent. What nobody’s really solved is recovery.
Patients still swell. They still hurt. They lean on opioids, and they largely do it alone. That gap is what inspired RESTORE: our Chief Medical Officer, Dr. Andrew Wickline, saw an opportunity to focus squarely on recovery and make sure patients feel educated and fully equipped to succeed.
The program is built on Dr. Wickline’s 10+ years of research and his own protocol, laid out in his book, “Less Pain, Less Swelling.”
What makes RESTORE different from the standard joint replacement experience, and where does the traditional model fall short?
The traditional model is fragmented. The surgeon owns the OR, the physical therapist owns the recovery visits, and the patient is responsible for virtually everything in between. When nobody is coordinating or has visibility into how things are actually going, patients feel isolated and left to figure it out on their own. Pain gets managed reactively, swelling gets undertreated, and patients are anxious because they don’t know what “normal” even looks like.
RESTORE flips that. It’s continuous instead of episodic, and it’s coordinated and data-informed, so you take the guesswork out of the surgical journey. There’s a real person quarterbacking the process, so nobody falls through the cracks.
Where does the data come from, and how is that different from a traditional recovery?
We partnered with WHOOP, a wearable device that gives us insight into specific metrics like steps, sleep, strain, and recovery, and allows the patient navigator and the surgeon to see how a patient is doing day-to-day. That helps us stay proactive and catch concerns early.
From your experience as a physical therapist, what does recovery typically look like without this level of support, and what changes when a patient has a dedicated navigator and a structured program?
This is the part I feel personally, because I’ve lived on the receiving end of the broken version. Without support, patients show up to therapy already behind: swollen, in pain, sometimes over-medicated, and often having done too much or too little because their care is fragmented. The fear is huge, too. A scared patient guards and stalls, and a lot of a physical therapist’s time gets spent fixing problems that were completely preventable.
With a navigator and a real program, patients arrive more informed. Swelling gets managed earlier, so they can actually participate in the things they love instead of just surviving a prolonged recovery. And I think the biggest shift is adherence. That goes up, not because we nag people, but because they stop feeling alone.
The recovery guide and workbook play into this too. A patient can see, day by day, exactly what’s expected of them. Paired with a patient navigator, that accountability layer is a big part of what drives adherence.
How do custom surgical planning and VR surgical simulation change outcomes for patients?
Recovery is only as good as the starting point you hand the patient. A custom plan means the surgical approach is already tailored to that person’s anatomy instead of a one-size-fits-all default.
When a surgeon can rehearse a specific case in VR simulation first, you’re cutting variability and time in the OR. That could mean less time under anesthesia, less trauma, and an easier recovery for the patient.
What does the RESTORE pilot look like right now?
The pilot is starting across three orthopedic practices in California, giving patients at each location the opportunity to be part of this first cohort. We’re running the program for 12 weeks from the start date at each practice. Once we gather feedback and data, we’ll refine the program before expanding. Our goal is to make RESTORE available to all Kinomatic surgeon partners in 2027.
What are you hoping to learn from this pilot? What would tell you it worked?
There are two layers to that. Clinically, we want to know if it actually moved the things we care about: less swelling, less pain, fewer opioids, faster milestones, and more confident patients. Operationally, we want to see if this can be repeatable and if it creates real value for practices and patients.
I’d call it a win if we see measurable opioid reduction, patients hitting milestones sooner and more reliably, and higher satisfaction. But the real tell will be whether the surgeons who finish this pilot want to keep doing it.
Walk us through what’s actually in the RESTORE bundle. What does each piece do for recovery?
This is the exciting part. The RESTORE Bundle is based on Dr. Wickline’s 10+ years of research and “Less Pain, Less Swelling” book and includes:
- Patient education, including a recovery guide and workbook. Think of this as the roadmap. It outlines how to prepare in the weeks leading up to surgery and what each recovery day looks like, which eases a patient’s anxiety.
- Essential amino acid supplements. Dr. Wickline’s research shows that using essential amino acids before and after surgery helps patients preserve 20% more muscle integrity two years after surgery.1 That matters because a procedure like this has a significant impact on muscle quality.
- A cryo-compression device to manage swelling and pain. Controlling swelling early could lead to decreased pain, earlier mobility, and fewer opioids needed.2
- A WHOOP wearable turns all of this into an actual, measurable trend. We get insight into heart rate variability, respiratory rate, sleep consistency, and overall performance, so we can see how a patient is really recovering, not just in the short term but over the long haul. It also tracks steps, which matters because part of this protocol is minimizing step count early on to prevent excessive swelling.
While these don’t arrive in a box, each RESTORE patient also receives:
- A custom surgical plan that’s created before surgery and gives the surgeon precise measurements and the opportunity to rehearse the case in a VR-simulated setting.
- A dedicated patient navigator who guides each patient through their entire surgical journey.
How does physical therapy factor into RESTORE?
Because the protocol calls for minimal to low activity in the first six weeks, there’s no formal physical therapy for patients during that window. After six weeks, depending on where a patient is in their recovery, the surgeon may recommend seeing a physical therapist to help them return to day-to-day activities.
In other words, patients skip the early days of leaving their house for post-op PT. Those are the visits patients find most difficult, where they’d have to come in within a day or two of surgery to be pushed through pain for mobility.
With RESTORE, that isn’t part of the experience. Patients can rest and recover at home, supported by their guided workbook and their Patient Navigator.
Is there anything in the bundle that would surprise patients?
Honestly, I think all of it would surprise them. People generally expect the surgical and clinical side to be the real value. To me, the treat is the 1:1 Patient Navigator check-ins. Each patient is paired with a dedicated Patient Navigator who becomes the person a patient relies on most throughout the process, whether it’s to ask a question or just to talk through what they’re going through. I think that ends up meaning more to patients than almost anything else in the program.
Having the support of someone in your corner flips a patient’s mindset to understand that this is truly designed to change their outcome from start to finish. And when a patient walks into surgery with that mindset already in place, they’ve already changed how they’re going to feel coming out of it.
What’s the most meaningful thing you’ve heard from a Kinomatic patient so far?
The most meaningful feedback I’ve personally heard was, “Why isn’t everyone doing this?”
One patient in particular had gone through multiple joint replacements in the past without this kind of support. She told me she loved the one-on-one touchpoints, that clear expectations were set, and that her care was actually coordinated with her surgeon, something she said she’d never experienced before. She was ready to walk a mile within the first two days, which was a surprise to her, and honestly, not something we advise.
What does “white glove” actually mean, day to day, for a RESTORE patient?
When people hear “white glove,” they think luxury. But really, it’s the difference between being accompanied and being processed. Day to day, it means somebody already knows your name and your case before you even pick up the phone. It means that when you’re staring at your knee at 8 p.m. wondering if the swelling is normal, you’re not spiraling through WebMD, you’re reaching out to someone and getting an answer.
For a patient, it feels like recovering with a team instead of recovering alone.
What would you want a patient considering joint replacement to know about RESTORE before they decide?
I would tell them that the surgery isn’t the hardest part. The recovery is.
Dr. Wickline’s research puts the entire surgical journey at roughly 3,000 hours of preparation and recovery, with only one hour of that being the surgery itself. So it’s not as simple as picking a great surgeon and letting recovery take care of itself, because it doesn’t.
RESTORE exists so patients are set up to succeed from day one, instead of being handed a paper instruction sheet and a bottle of opioids. I’d advise anyone considering surgery to take their recovery as seriously as they take picking their surgeon.
Would you say RESTORE gives patients their best chance at a great outcome?
In my opinion, yes. Most patients who come to us have already exhausted other treatment options before they ever consider surgery. So going into this program knowing they’ll get a custom surgical plan, a guided and supported recovery, and will likely need little to no opioids means a lot to people who’ve spent months, if not years, in pain and worried.
Patients who complete the program taking 10 or fewer opioids are also enrolled in March 2 A Million, Dr. Wickline’s nonprofit working toward a million orthopedic surgeries completed with little to no opioid use. It connects RESTORE patients to a national movement, not just an individual recovery.
Kinomatic RESTORE is currently piloting at three orthopedic practices in California, with plans to expand to additional surgeon partners in 2027.
Meet the pilot surgeons
Alexander P. Sah, MD
Hip + Knee Replacement
Sah Orthopaedic Associates
Fremont, CA
Jason K. Hofer, MD
Hip + Knee Replacement
Ventura Orthopedics
Ventura County, CA
Aaron K. Salyapongse, MD
Hip + Knee Replacement
Stanford Health Care Tri-Valley
Pleasanton, CA