Skip to main content
Top
Published in: HSS Journal ® 2/2020

01-12-2020 | Osteoarthrosis | Original Article

Monitoring Patient Recovery After THA or TKA Using Mobile Technology

Authors: Stephen Lyman, PhD, Chisa Hidaka, MD, Kara Fields, MS, Wasif Islam, BS, David Mayman, MD

Published in: HSS Journal ® | Special Issue 2/2020

Login to get access

Abstract

Background

Smartphones offer the possibility of assessing recovery of mobility after total hip or knee arthroplasty (THA or TKA) passively and reliably, as well as facilitating the collection of patient-reported outcome measures (PROMs) with greater frequency.

Questions/Purposes

We investigated the feasibility of using mobile technology to collect daily step data and biweekly PROMs to track recovery after total joint arthroplasty.

Methods

Pre- and post-operative daily steps were recorded in prospectively enrolled patients (128 THA and 139 TKA) via an app, which uses the phone’s accelerometer. During 6-month follow-up, patients also completed PROMs (the pain numeric rating scale, the Hip Disability and Osteoarthritis Outcome Score Joint Replacement [HOOS JR] and the Knee Injury and Osteoarthritis Outcome Score Joint Replacement [KOOS JR]), and HOOS or KOOS JR quality of life domain via a mobile-enabled web link.

Results

At least 6 months of follow-up was completed by 65% for THA and 68% for TKA patients. Reasons for non-completion included time commitment, phone battery, app issues, and health complications. Responses from 78% of requested PROMs were returned with 96% of patients returning at least one post-operative PROM. Step data were available from 92% of days from male patients and 86% of days from female patients. The most robust recovery occurred early, within the first 2 months. The groups with higher pre-operative steps were more likely to recover their maximum daily steps at an earlier time point. Correlations between step counts and PROMs scores were modest.

Conclusion

Assessing large amounts of post-TKA and post-THA step data using mobile technology is feasible. Completion rates were good, making the technology very useful for collecting frequent PROMs. Being unable to ensure that patients always carried their phones limited our analysis of the step counts.
Appendix
Available only for authorised users
Literature
7.
go back to reference Dehling T, Gao F, Schneider S, Sunyaey A. Exploring the far side of mobile health: information security and privacy of mobile health apps on iOS and Android. JMIR Mhealth Uhealth. 2015;3(1):e8. Dehling T, Gao F, Schneider S, Sunyaey A. Exploring the far side of mobile health: information security and privacy of mobile health apps on iOS and Android. JMIR Mhealth Uhealth. 2015;3(1):e8.
10.
go back to reference Fujita K, Makimoto K, Tanaka R, Mawatari M. Prospective study of physical activity and quality of life in Japanese women undergoing total. Epidemiology. 1997;50:239–46. Fujita K, Makimoto K, Tanaka R, Mawatari M. Prospective study of physical activity and quality of life in Japanese women undergoing total. Epidemiology. 1997;50:239–46.
13.
go back to reference Kennedy DM, Stratford PW, Riddle DL, Hanna SE, Gollish JD. Assessing recovery and establishing prognosis following total knee arthroplasty. Phys Ther. 2008;88:22–32. Kennedy DM, Stratford PW, Riddle DL, Hanna SE, Gollish JD. Assessing recovery and establishing prognosis following total knee arthroplasty. Phys Ther. 2008;88:22–32.
14.
go back to reference Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord. 2005;6. doi:https://doi.org/10.1186/1471-2474-6-3. Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord. 2005;6. doi:https://​doi.​org/​10.​1186/​1471-2474-6-3.
15.
go back to reference Kim K, Pham D, Schwarzkopf R. Mobile application use in monitoring patient adherence to perioperative total knee arthroplasty protocols. Surg Technol Int. 2016;28:253–260. Kim K, Pham D, Schwarzkopf R. Mobile application use in monitoring patient adherence to perioperative total knee arthroplasty protocols. Surg Technol Int. 2016;28:253–260.
19.
go back to reference Lingard EA, Berven S, Katz JN. Management and care of patients undergoing total knee arthroplasty: variations across different health care settings. Arthritis Care Res 2000;13:129–36. Lingard EA, Berven S, Katz JN. Management and care of patients undergoing total knee arthroplasty: variations across different health care settings. Arthritis Care Res 2000;13:129–36.
20.
go back to reference Lützner C, Kirschner S, Lützner J. Patient activity after TKA depends on patient-specific parameters. Clin Orthop Relat Res. 2014;472(12):3933–3940.CrossRef Lützner C, Kirschner S, Lützner J. Patient activity after TKA depends on patient-specific parameters. Clin Orthop Relat Res. 2014;472(12):3933–3940.CrossRef
26.
go back to reference Naylor J, Harmer A, Fransen M, Crosbie J, Innes L. Status of physiotherapy rehabilitation after total knee replacement in Australia. Physiother Res Int. 2006;11:35–47.CrossRef Naylor J, Harmer A, Fransen M, Crosbie J, Innes L. Status of physiotherapy rehabilitation after total knee replacement in Australia. Physiother Res Int. 2006;11:35–47.CrossRef
28.
go back to reference O’Brien S, Bennett D, Doran E, Beverland DE. Comparison of hip and knee arthroplasty outcomes at early and intermediate follow-up. Orthopedics. 2009;32:168.CrossRef O’Brien S, Bennett D, Doran E, Beverland DE. Comparison of hip and knee arthroplasty outcomes at early and intermediate follow-up. Orthopedics. 2009;32:168.CrossRef
34.
35.
go back to reference Schmalzried TP, Szuszczewicz ES, Northfield MR, et al. Quantitative assessment of walking activity after total hip or knee replacement. J Bone Joint Surg Am. 1998;80:54–59. Schmalzried TP, Szuszczewicz ES, Northfield MR, et al. Quantitative assessment of walking activity after total hip or knee replacement. J Bone Joint Surg Am. 1998;80:54–59.
37.
go back to reference Stratford PW, Kennedy DM, Maly MR, MacIntyre NJ. Quantifying self-report measures’ overestimation of mobility scores postarthroplasty. Phys Ther. 2010;90:1288–1296.CrossRef Stratford PW, Kennedy DM, Maly MR, MacIntyre NJ. Quantifying self-report measures’ overestimation of mobility scores postarthroplasty. Phys Ther. 2010;90:1288–1296.CrossRef
Metadata
Title
Monitoring Patient Recovery After THA or TKA Using Mobile Technology
Authors
Stephen Lyman, PhD
Chisa Hidaka, MD
Kara Fields, MS
Wasif Islam, BS
David Mayman, MD
Publication date
01-12-2020
Publisher
Springer US
Published in
HSS Journal ® / Issue Special Issue 2/2020
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-019-09746-3

Other articles of this Special Issue 2/2020

HSS Journal ® 2/2020 Go to the issue