Variation and Slower-Than-Recommended Recovery of Daily Life Activities Following Knee Arthroplasty with a Personalized eHealth Program: Results of the ACTIVE Trial Intervention Cohort.

Abstract

The rising prevalence of knee arthroplasty (KA) affects daily life, especially for working-age patients who have high expectations for resuming activities. Variability in guidelines and lack of personalized recovery recommendations highlight the need for improved guidance, such as through eHealth solutions. This study identifies the most important daily activities chosen in an eHealth application and evaluates patients' recovery times compared to expert recommendations. Data from the intervention group of the Dutch ACTIVE trial were analyzed (n = 145, mean age 58 (range, 46 to 66); 54% women); 133 of these patients started follow-up. Patients used an app, which provided expert-based personalized recommendations for 27 activities, all with three recovery speeds, for unicompartmental and total KA: slow, average, and fast. We analyzed activity choices and compared actual resumption times with the expert recommendations. The top activities included cycling (92%), driving (88%), and lifting/carrying (73%). In 79% of cases, actual median recovery time exceeded recommendations. For total knee arthroplasty (TKA) patients in average and fast recovery groups, climbing stairs (52 and 46%) and walking on even terrain (50 and 53%) most often matched recommendations. Generally, recovery was slower than the provided recommendations, with eight out of 10 activities not resumed within the recommended time. This highlights the need to refine recommendations for returning to daily activities, including work and sports.