The monitoring of activity at home after total hip arthroplasty.
OBJECTIVE
Total hip arthroplasty (THA) has well known subjective benefits, but little is known objectively about the recovery of mobility in the early post-operative period.


METHODS
A total of 33 patients aged > 60 years who underwent elective primary THA had their activity monitored for 30 days post-operatively using an at-home (Fitbit) ankle accelerometer. Their mean age was 70.7 years (61 to 86); 15 (45.5%) were female. The rate of compliance and the mean level of activity were determined. Comparisons between subgroups based on age, body mass index (BMI), surgical approach, and the destination of the patients when discharged were also performed.


RESULTS
The mean compliance over the 30 days was 26.7 days (16 to 30; 89%) of use. The mean number of steps increased from 235 (5 to 1152) to 2563 (87 to 7280) (p < 0.001) between the first and the 30th post-operative day. Age < 70 years and an anterior surgical approach were significantly associated with higher levels of activity (1600 to 2400 (p = 0.016 to 0.031) and 1000 to 1800 (p = 0.017 to 0.037) more steps per day, respectively) between the second and the fourth week post-operatively. There was also a trend towards higher levels of activity in those who were discharged to their home rather than to a nursing facility (a mean of 1500 more steps per day, p = 0.02). BMI greater or less than 30 kg/m2was not predictive of activity (p = 0.45 to 0.98).


CONCLUSIONS
At-home remote mobility monitoring using existing commercially available technology is feasible in patients who have undergone THA. It showed a clear trend towards increased activity with the passage of time. Additionally, the remote device was able to detect differences in levels of activity clearly between patients in relation to variables of interest including age, BMI, surgical approach, and the destination of the patient at the time of discharge from hospital. Such monitoring may allow for the early identification and targeted intervention in patients who recover slowly. Cite this article: Bone Joint J 2016;98-B:1450-4.
Mayo Clinic, Gonda Building, 200 First St. SW, Rochester, MN 55905, USA.
P A
PA
Toogood
Mayo Clinic, Gonda Building, 200 First St. SW, Rochester, MN 55905, USA.
M P
MP
Abdel
Mayo Clinic, Gonda Building, 200 First St. SW, Rochester, MN 55905, USA.
J A
JA
Spear
Mayo Clinic, Gonda Building, 200 First St. SW, Rochester, MN 55905, USA.
S M
SM
Cook
Mayo Clinic, Gonda Building, 200 First St. SW, Rochester, MN 55905, USA.
D J
DJ
Cook
Mayo Clinic, Gonda Building, 200 First St. SW, Rochester, MN 55905, USA.
M J
MJ
Taunton
D061725:Accelerometry / Q000379:methods; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000534:rehabilitation*; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D013686:Telemetry / Q000379:methods*
Age; At-home activity monitoring; Primary total hip arthroplasty; Steps per day; Surgical approach