Background: Little is known about the long-term changes in physical activity (PA) after total hip arthroplasty (THA). The purpose of this study is to describe the changes in the number of steps and intensity of PA as measured by accelerometers, patient-reported physical function, and health-related quality of life of THA patient preoperatively and at 1 and 3 years after THA. Methods: This study included 153 patients (mean age, 61.4 years; 86.3% women) who wore an accelerometer for 10 consecutive days and completed the Oxford Hip Score (OHS) and the Short Form 8 at the 5-year follow-up after THA. PA was evaluated based on the mean steps per day and the time spent performing moderate-to-vigorous PA (MVPA) per week. Results: All 5 indicators had significantly increased at 1 year after THA, although only MVPA and OHS had further increased significantly at the 3-year follow-up. The predictor of improvement in the number of steps from baseline to 1 year post-THA was younger age, while those of improvement in MVPA from baseline to 3-year post-THA were younger age, higher OHS, and better Short Form 8 mental component scores using mixed-model analysis. Participation in the PA measurements was high (69.9%) at the 3-year follow-up. No significant changes were observed for these outcomes in the remaining cohort beyond 3 years after THA. Conclusion: In post-THA patients, MVPA continued to increase for 3 years postoperatively. Therefore, PA must be measured over the medium term to long term following THA.

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We evaluated nocturnal sleep-wake rhythms and subjective sleep quality on the first postoperative night compared with the preoperative night in 34 patients who had total hip arthroplasty (mean age: 61.9 years; 82.4% female) under spinal anaesthesia. We also examined secondary factors related to sleep disturbances after surgery. Patients wore an accelerometer (actigraph) during the preoperative period and the first postoperative night to track sleep-wake rhythms. Secondary end-points were postsurgical pain and low back pain. Sleep parameters were measured objectively by actigraphy, and subjective sleep quality was measured by the Oguri-Shirakawa-Azumi Sleep Inventory, Middle-Aged and Aged Version and found to worsen significantly after surgery. Actigram data showed a reduction in actual sleep time from 353.7 ± 121.2 min preoperatively to 263.8 ± 104.4 min postoperatively. The data indicate that normalized continuous sleep time is important for patient healing and well-being and that postoperative sleep disturbance is related to low back pain more than to postsurgical pain.

Purpose: There is insufficient evidence regarding the precise levels of physical activity (PA) in older patients following total knee arthroplasty (TKA). The aims of this study were (1) to describe the changes in the amount and intensity of PA before and after TKA with an accelerometer in older patients, compared with age- and sex-matched healthy participants and (2) to assess the effect of TKA on PA depending on age. Methods: Sixty-six primary TKA patients aged 60 years or over (mean age, 73.3 years) wore an accelerometer (Lifecorder EX) for 10 consecutive days and completed the Oxford Knee Score (OKS) before and at 6 months after TKA. PA was evaluated by mean step count and time spent (min) engaged in PA per day. PA intensity was classified as light (1.5–3 metabolic equivalents (METs)), moderate to vigorous (≥3 METs), and total (≥1.5 METs). Sixty-four healthy participants completed a single assessment of PA. Results: Each of the PA measures and OKS increased significantly after TKA. Compared with healthy controls, light and total PA improved to 100% at 6 months after TKA in patients 75 years or older. By contrast, moderate-to-vigorous PA was 32% of that of the controls and rose to 78% after TKA. PA intensity in patients aged 60–74 years was 31–74% of the controls but did not reach the same level after TKA. Conclusion: TKA in older patients increases the amount of PA, with light and total PA suitable parameters for assessing PA.

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