Abstract：
BACKGROUND: Wearable devices provide the ability for clinical teams to continuously monitor patients\' rehabilitation progress with objective data. Understanding expected recovery patterns following total knee arthroplasty (TKA) enables prompt identification of patients failing to meet these milestones. The aim of this study was to establish normative values for daily functional recovery in the first 6 weeks after TKA using a wearable device.
METHODS: This prospective study included patients who underwent TKA between 2020 and 2023, treated by 11 surgeons from 8 institutions. Eligible participants were aged 18 or older, had a primary unilateral TKA, and owned a smartphone. Knee range of motion, total daily steps, cadence, and device usage were measured continuously over 6 weeks. Statistical analysis included analysis of variance using post hoc Tukey honest significant difference tests.
RESULTS: The cohort of 566 participants had a mean age of 65 and 69 for men and women, respectively (range, 50 to 80). Women comprised 61% (n = 345) of study participants. There were 82% of women and 90% of men who had a body mass index > 30. The average daily wear time of the device was 12 hours (±4) for a total of 45 days (±27). Recovery was nonlinear, with the greatest gains in the first 3 weeks postsurgery for all metrics. Men demonstrated greater total daily step counts and cadence when compared to women. Obese patients demonstrated poorer performance when compared to lower body mass index patients.
CONCLUSIONS: To our knowledge, this study presents the first normative data for tracking daily functional recovery in TKA patients using wearable sensors. Standardizing the TKA recovery timeline allows surgeons to isolate factors affecting patients\' healing processes, accurately counsel them preoperatively, and intervene more promptly postoperatively when rehabilitation is not within standard recovery parameters.
METHODS: This prospective study included patients who underwent TKA between 2020 and 2023, treated by 11 surgeons from 8 institutions. Eligible participants were aged 18 or older, had a primary unilateral TKA, and owned a smartphone. Knee range of motion, total daily steps, cadence, and device usage were measured continuously over 6 weeks. Statistical analysis included analysis of variance using post hoc Tukey honest significant difference tests.
RESULTS: The cohort of 566 participants had a mean age of 65 and 69 for men and women, respectively (range, 50 to 80). Women comprised 61% (n = 345) of study participants. There were 82% of women and 90% of men who had a body mass index > 30. The average daily wear time of the device was 12 hours (±4) for a total of 45 days (±27). Recovery was nonlinear, with the greatest gains in the first 3 weeks postsurgery for all metrics. Men demonstrated greater total daily step counts and cadence when compared to women. Obese patients demonstrated poorer performance when compared to lower body mass index patients.
CONCLUSIONS: To our knowledge, this study presents the first normative data for tracking daily functional recovery in TKA patients using wearable sensors. Standardizing the TKA recovery timeline allows surgeons to isolate factors affecting patients\' healing processes, accurately counsel them preoperatively, and intervene more promptly postoperatively when rehabilitation is not within standard recovery parameters.
摘要：
背景：可穿戴设备为临床团队提供了利用客观数据持续监测患者康复进展的能力。了解全膝关节置换术（TKA）后的预期恢复模式，可以迅速识别未能达到这些里程碑的患者。这项研究的目的是在使用可穿戴设备进行TKA后的前六周内建立每日功能恢复的标准值。
方法：这项前瞻性研究包括在2020年至2023年期间接受TKA的患者，由来自8个机构的11名外科医生治疗。符合条件的参与者年龄在18岁或以上，患有原发性单侧TKA，并拥有一部智能手机。膝盖运动范围（ROM），每日总步数(TDS)，节奏,和设备使用情况在六周内连续测量。统计学分析包括使用事后Tukey诚实显著差异检验(HSD)的方差分析(ANOVA)。
结果：566名参与者的男性和女性的平均年龄分别为65岁和69岁，分别(范围，50至80）。女性占研究参与者的61％（n=345）。有82%的女性和90%的男性的体重指数(BMI)>30。装置的平均每日佩戴时间为12小时(±4),共45天(±27)。恢复是非线性的，所有指标在术后前3周的收益最大。与女性相比，男性表现出更大的每日步数和步调。与BMI较低的患者相比，肥胖患者表现较差。
结论：据我们所知，这项研究提供了首次使用可穿戴传感器跟踪TKA患者日常功能恢复的规范数据.标准化TKA恢复时间表允许外科医生分离影响患者愈合过程的因素，术前准确地为他们提供咨询，当康复不在标准康复参数范围内时，术后更及时地进行干预。
方法：这项前瞻性研究包括在2020年至2023年期间接受TKA的患者，由来自8个机构的11名外科医生治疗。符合条件的参与者年龄在18岁或以上，患有原发性单侧TKA，并拥有一部智能手机。膝盖运动范围（ROM），每日总步数(TDS)，节奏,和设备使用情况在六周内连续测量。统计学分析包括使用事后Tukey诚实显著差异检验(HSD)的方差分析(ANOVA)。
结果：566名参与者的男性和女性的平均年龄分别为65岁和69岁，分别(范围，50至80）。女性占研究参与者的61％（n=345）。有82%的女性和90%的男性的体重指数(BMI)>30。装置的平均每日佩戴时间为12小时(±4),共45天(±27)。恢复是非线性的，所有指标在术后前3周的收益最大。与女性相比，男性表现出更大的每日步数和步调。与BMI较低的患者相比，肥胖患者表现较差。
结论：据我们所知，这项研究提供了首次使用可穿戴传感器跟踪TKA患者日常功能恢复的规范数据.标准化TKA恢复时间表允许外科医生分离影响患者愈合过程的因素，术前准确地为他们提供咨询，当康复不在标准康复参数范围内时，术后更及时地进行干预。
