Efficacy of Lower Limb Wearables to Assess Recovery Following Total Hip or Knee Arthroplasty: A Systematic Review and Meta-Analysis.

Abstract

The purpose of this review was to assess the use of lower-limb wearable sensors in monitoring total hip arthroplasty (THA) or total knee arthroplasty (TKA) recovery. Outpatient postoperative assessment routinely focuses on patient-reported outcome measures (PROMs), which can be limited by ceiling effects and subjective reporting. Wearable sensors provide objective, real-time, remote data, enabling recovery tracking, rehabilitation protocol adjustments, and patient exercise adherence. Lower-limb sensors are particularly useful, as close proximity allows monitoring of clinical outcomes specific to the affected joint. Embase, PubMed, Scopus, and Web of Science were searched to identify studies on monitoring following arthroplasty. Included articles employed lower-limb wearable devices for continuous, at-home, postoperative monitoring within 18 months of surgery in patients who underwent THA or TKA. Outcomes of interest included PROMs and objective physical activity. Of 532 screened articles, 10 were included; five investigated TKA patients, while five focused on THA. Objective metrics included step counts (n = eight) and range of motion (n = four). Postoperative outcomes showed significant improvements in the Oxford Hip Score (P < 0.001), Oxford Knee Score (P = 0.020), and University of California, Los Angeles Activity Index (P < 0.001) at three, six, and 12 months postoperatively, respectively. While no significant change in daily steps was noted within six months postoperatively, it significantly increased at final follow-up, within one year of surgery, with TKA and THA patients demonstrating comparable improvements. The integration of lower-limb wearables into postoperative care for TKA and THA presents an innovative approach to monitoring recovery. Findings from this analysis show differences between TKA and THA, suggesting a unique trajectory for each surgery.