Huffman Nickelas, Pasqualini Ignacio, Khan Shujaa T, Klika Alison K, McLaughlin John P, Higuera-Rueda Carlos A, Deren Matthew E, Piuzzi Nicolas S
Department of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.
Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, 33331, USA.
Arch Orthop Trauma Surg. 2024 Dec 21;145(1):80. doi: 10.1007/s00402-024-05618-6.
There is conflicting data in the literature regarding the clinical utility of wearable devices. This study examined the association between patient reported outcome measures (PROMs) and step and stair flight counts obtained from wearable devices in postoperative total hip arthroplasty (THA) patients.
Data was collected from a multicenter prospective longitudinal cohort study from October 2018 to February 2022. A smartphone-based platform with smartwatch was utilized for collection of daily step and stair flight counts. Subjects (N = 1644) completed the Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR) and numerical rating scale (NRS) pain scores preoperatively and at 1 and 3 months postoperatively. Patients who reported living in a multi-level home (N = 931) were included in analysis of stair flight counts. Pearson correlation coefficients were calculated to determine correlations between step and stair flight counts with NRS pain and HOOS JR scores.
Step counts demonstrated a weak negative correlation to NRS pain scores at preoperative (r = - 0.15, p < 0.0001), 1-month (r = - 0.15, p < 0.0001), and 3-months follow-up (r = - 0.06, p = 0.05). Step counts demonstrated a weak positive correlation with HOOS JR scores at preoperative (r = 0.16, p < 0.0001), 1-month (r = 0.15, p < 0.0001), and 3-months (r = 0.13, p < 0.0001). Stair flight counts demonstrated a weak negative correlation with NRS pain preoperatively (r = - 0.19, p < 0.0001) and at 1-month (r = - 0.11, p = 0.003). Stair flight counts positively correlated with HOOS JR scores at preoperative (r = 0.24, p < 0.0001), 1-month (r = 0.15, p < 0.0001), and 3-months (r = 0.09, p = 0.02).
The utilization of wearable technology can enhance the evaluation of patient outcomes after THA, primarily due to the observed correlation between data collected from wearables and PROMs. Our study highlights the importance of the use of objective data, in addition to subjective patient reported data, when analyzing postoperative patient progress, which propels forward the field of postoperative THA patient care.
关于可穿戴设备的临床效用，文献中的数据存在冲突。本研究调查了术后全髋关节置换术（THA）患者的患者报告结局指标（PROMs）与从可穿戴设备获得的步数和楼梯步数之间的关联。
数据收集自2018年10月至2022年2月的一项多中心前瞻性纵向队列研究。利用一个基于智能手机的平台和智能手表来收集每日步数和楼梯步数。受试者（N = 1644）在术前、术后1个月和3个月完成了关节置换的髋关节残疾和骨关节炎结局评分（HOOS JR）以及数字评分量表（NRS）疼痛评分。报告居住在多层住宅的患者（N = 931）被纳入楼梯步数分析。计算Pearson相关系数以确定步数和楼梯步数与NRS疼痛及HOOS JR评分之间的相关性。
步数在术前（r = -0.15，p < 0.0001）、1个月时（r = -0.15，p < 0.0001）和3个月随访时（r = -0.06，p = 0.05）与NRS疼痛评分呈弱负相关。步数在术前（r = 0.16，p < 0.0001）、1个月时（r = 0.15，p < 0.0001）和3个月时（r = 0.13，p < 0.0001）与HOOS JR评分呈弱正相关。楼梯步数在术前（r = -0.19，p < 0.0001）和1个月时（r = -0.11，p = 0.003）与NRS疼痛呈弱负相关。楼梯步数在术前（r = 0.24，p < 0.0001）、1个月时（r = 0.15，p < 0.0001）和3个月时（r = 0.09，p = 0.02）与HOOS JR评分呈正相关。
可穿戴技术的应用可以加强对THA术后患者结局的评估，这主要是由于从可穿戴设备收集的数据与PROMs之间存在观察到的相关性。我们的研究强调了在分析术后患者进展时，除了患者报告的主观数据外，使用客观数据的重要性，这推动了THA术后患者护理领域的发展。
