{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:03:46Z","timestamp":1790741026815,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Wearable technologies, like the Apple Watch, offer new possibilities for collecting objective data on physical activity post\u2010operatively following total knee arthroplasty (TKA). This study aims to describe changes in daily physical activity levels using objective metrics over different time points following TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study analyzed data from a prospective cohort of 152 patients undergoing a unilateral TKA. Patients wore an Apple Watch and used a digital care management application for data collection. Step count, steadiness, standing duration, gait speed and performance on a 6\u2010min walk test were collected from Apple HealthKit at multiple time points: pre\u2010operative, 6 weeks post\u2010operatively, 6 months post\u2010operatively and 12 months post\u2010operatively. Statistical analyses were performed using R software, including descriptive statistics and paired\n                      <jats:italic>t<\/jats:italic>\n                      tests to compare outcomes at different time points post\u2010operatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants demonstrated significant improvements in daily physical activity levels over the course of 12 months post\u2010operative. At 6 months post\u2010operative, participants showed the highest average daily step count (mean\u2009\u00b1\u2009SD: 5293\u2009\u00b1\u2009236 steps;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with improvements persisting at 12 months post\u2010operative (5180\u2009\u00b1\u2009260 steps;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to preoperative values. Gait speed increased from 0.88\u2009\u00b1\u20090.01\u2009m\/s preoperatively to 1.01\u2009\u00b1\u20090.01\u2009m\/s (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) at 12 months post\u2010operative. Standing hours increased from 9.99\u2009\u00b1\u20090.30 to 11.47\u2009\u00b1\u20090.31\u2009h at 6 months post\u2010operative and persisted. Steadiness and the estimated 6\u2010minute walk test showed recovery trends, though variability remained at 12 months post\u2010operative, suggesting the need for additional longitudinal assessment\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides one of the first longitudinal analyses of post\u2010operative functional recovery using Apple HealthKit, offering continuous real\u2010world gait and activity tracking beyond traditional patient\u2010reported measures. These findings highlight the value of wearable technology in monitoring post\u2010operative activity and offering insights into TKA recovery patterns. The study suggests a critical recovery window at 6 months post\u2010operative and emphasizes the need for ongoing support to maintain improvements. The integration of wearable technology in post\u2010operative monitoring offers a promising approach to tracking patient progress and optimizing functional outcomes following TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.12675","type":"journal-article","created":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T08:31:36Z","timestamp":1744533096000},"page":"3218-3227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Wearable health technology finds improvements in daily physical activity levels following total knee arthroplasty: A prospective study"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8296-1152","authenticated-orcid":false,"given":"Kevin A.","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Kugelman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul K.","family":"Goel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric S.","family":"Dilbone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devika","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean P.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel S.","family":"Wellman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Bolognesi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten M.","family":"Seyler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-023-07375-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/s21155143"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.03.060"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.02.030"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.01061"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-024-03953-3"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/s23125588"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-07306-3"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2196\/18694"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753944719870084"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2340\/jrm.v56.18326"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2024.05.091"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2024.02.003"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.26.BJO-2021-0053.R1"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.04.049"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.12542"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000002008"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2024.103842"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjdh\/ztab018"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12547"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2007.02.009"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2020.07.006"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07025-z"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.10.012"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07165-2"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2196\/13756"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.OA.22.00112"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.2196\/39637"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.07.086"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jeo2.70048"},{"key":"e_1_2_11_32_1","article-title":"How do patient\u2010reported outcomes correlate with real\u2010time objective measures of function after total knee arthroplasty? A prospective study using daily gait metrics","author":"Wu KA","year":"2024","journal-title":"J Arthroplasty"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2024.05.003"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.9754"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22772"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0022-4707.18.08339-1"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.12675","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T12:08:08Z","timestamp":1760875688000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.12675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,13]]},"references-count":35,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/ksa.12675"],"URL":"https:\/\/doi.org\/10.1002\/ksa.12675","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,13]]},"assertion":[{"value":"2024-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}