Wearable activity sensors and early pain after total joint arthroplasty

Abstract

A prospective observational cohort of 20 primary total hip arthroplasty (n ¼ 12) and total knee arthroplasty (n ¼ 8) patients (mean age: 63 ± 6 years) was passively monitored with a consumer-level wearable activity sensor before and 6 weeks after surgery. Patients were clustered by minimal change or decreased activity using sensor data. Decreased postoperative activity was associated with greater pain reduction (À5.5 vs À2.0, P ¼ .03). All patients surpassed minimal clinical benefit thresholds of total joint arthroplasty (TJA) (Hip Disability and Osteoarthritis Score Junior 30.5 vs 20.8, P ¼ .23; Knee Injury and Osteoarthritis Outcome Score Junior 23.3 vs 18.2, P ¼ .77) within 6 weeks. Patients who objectively "take it easy" after TJA may experience less pain with no difference in early subjective outcome. Remote, passive analysis of outpatient wearable sensor data may permit real-time detection of early problems after TJA.

Assessing Pelvic Tilt in Patients Undergoing Total Hip Arthroplasty Using Sensor Technology

“…Increasing use of wearable technology in orthopedic surgery results in a rapid improvement of sensor technology that can be utilized for preoperative evaluation of patients as well as intraoperative guidance and postoperative monitoring and follow-up [ 20 , [23] , [24] , [25] , [26] , [27] , [28] ]. The use of wearable sensors is a safe, rapid, and efficient way to detect pelvic mobility in patients, including those with low back pain or those requiring spinopelvic evaluation [ [36] , [37] , [38] ].…”

“…With an increased interest in noninvasive wearable technology for research and clinical use, there remains a need to validate and determine the most effective, efficient, and accurate devices [ 29 ]. Not only can wearable technology be utilized during the preoperative evaluation process to help guide surgical decision-making, but such devices can be used for direct monitoring of postoperative outcomes and follow-up as well as for evaluation of functional biomechanics [ 20 , [23] , [24] , [25] , [26] , [27] , [28] ]. Studies in the literature evaluating wearable technology for spinopelvic motion analysis report promising results.…”

“…In lieu of this equipment, wearable devices can be considered for use in the preoperative setting as well as for postoperative evaluation of patients. Recent literature has demonstrated that the utilization of such technology has been exponentially expanding in orthopedic surgery as well as all areas of medicine [ [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] ]. Continued innovation in this sector has allowed for a variety of uses in providing both patients and surgeons with data to optimize treatment, and orthopedic surgeons may be able to capitalize on these clinical tools to facilitate simpler and more cost-efficient methods to obtaining vital patient information.…”

Real-world patient data: Can they support decision making and patient engagement?

“…PGHD has the potential to support personalized health care delivery. For example, using a consumer-level wearable sensor to monitor patients' activity level after total joint arthroplasty, Patterson et al found that patients who were objectively more sedentary early in their recovery experienced less pain without compromising subjective health outcomes measured by PROMs [76] . Actively and passively captured 'digital biomarkers' quantify health status and enable digital phenotyping, defined as the "moment-bymoment quantification of individual human phenotypes in situ using data from personal digital devices, in particular smartphones" [77] .…”

Wearable Devices: Current Status and Opportunities in Pain Assessment and Management

“…Perraudin et al [70] also studied patients with arthritis but used wearable accelerometers to assess the duration of an unsupervised 5 Times Sit to Stand Test in the morning, and they found that the duration of the test was significantly associated with pain, particularly upon waking and overnight. In relation to postoperative pain, Patterson et al [87] found that decreased postoperative activity was associated with a greater reduction in pain scores among patients who underwent knee and hip replacements.…”