Total hip arthroplasty improves pain and function but not physical activity

Background: People with hip osteoarthritis are likely to limit physical activity (PA) engagement due to pain and lack of function. Total hip arthroplasty (THA) reduces pain and improves function, potentially allowing increased PA. PA of THA patients was quantified to 12m post-operation. The hypothesis was that post-operatively levels of PA would increase. Methods: PA of 30 THA patients (67±7 years) was objectively measured pre-operatively and three and 12 months post-operation. Harris Hip Score (HHS), Oxford Hip Score (OHS) and six minute walk test (6MWT) were recorded. Mixed linear modelling was used to examine relationships of outcomes with time, baseline BMI, age, gender and baseline HHS. Results: Time was not a significant factor in predicting volume measures of PA, including sit-to-stand transitions, upright time and steps. Notably baseline BMI was a significant predictor of upright time, steps, largest number of steps in an upright bout, HHS and 6MWT. Baseline HHS helped predict longest upright bout, cadence of walking bouts >60s and OHS. The significant effect of participant as a random intercept in the model for PA outcomes suggested habituation from pre- to post-surgery. Conclusions: Volume measures of PA did not change from pre- to 12m post-surgery despite improvement in HHS, OHS and 6MWT. Baseline BMI was a more important predictor of upright activity and stepping than time. Pre- and post-operative PA promotion could be used to modify apparently habitual low levels of PA to enable full health benefits of THA to be gained

A review of wearable motion tracking systems used in rehabilitation following hip and knee replacement

Clinical teams are under increasing pressure to facilitate early hospital discharge for total hip replacement and total knee replacement patients following surgery. A wide variety of wearable devices are being marketed to assist with rehabilitation following surgery. A review of wearable devices was undertaken to assess the evidence supporting their efficacy in assisting rehabilitation following total hip replacement and total knee replacement. A search was conducted using the electronic databases including Medline, CINAHL, Cochrane, PsycARTICLES, and PubMed of studies from January 2000 to October 2017. Five studies met the eligibility criteria, and all used an accelerometer and a gyroscope for their technology. A review of the studies found very little evidence to support the efficacy of the technology, although they show that the use of the technology is feasible. Future work should establish which wearable technology is most valuable to patients, which ones improve patient outcomes, and the most economical model for deploying the technolog