{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:20:34Z","timestamp":1783527634298,"version":"3.55.0"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Oxford Clarendon Scholarship Fund","award":["University of Oxford Clarendon Scholarship Fund"],"award-info":[{"award-number":["University of Oxford Clarendon Scholarship Fund"]}]},{"name":"Joint-PhD award program scholarship from the University of Manchester and the University of Melbourne","award":["Joint-PhD award program scholarship from the University of Manchester and the University of Melbourne"],"award-info":[{"award-number":["Joint-PhD award program scholarship from the University of Manchester and the University of Melbourne"]}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1194428"],"award-info":[{"award-number":["1194428"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014653","name":"Manchester Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203308"],"award-info":[{"award-number":["NIHR203308"]}],"id":[{"id":"10.13039\/100014653","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["223100\/Z\/21\/Z"],"award-info":[{"award-number":["223100\/Z\/21\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Effective patient education and activity expectation-setting following knee replacement requires understanding postoperative recovery patterns. We investigated step-count recovery patterns, identified recovery trajectory clusters, and examined differences in postoperative outcomes and preoperative factors associated with those clusters. Using wrist-worn accelerometer, step-counts were measured for one week preoperatively and six weeks postoperatively in patients with knee osteoarthritis undergoing total or unicompartmental knee replacement (UKR). Patient-reported outcomes (OKS, EQ-5D-3L, EQ-VAS) were collected preoperatively and at six postoperative weeks. The proportion of participants exceeding their preoperative step-count was calculated. Latent class growth analysis identified trajectories of absolute (postoperative) and relative (postoperative-to-preoperative ratio) step-counts. Kruskal\u2013Wallis with Dunn\u2019s test assessed differences in postoperative outcomes across trajectories, and multinomial logistic regression assessed associations between trajectories and preoperative factors. Eighty-two participants (aged 42\u201389 years; 52% women) were included. Within six weeks, 32% exceeded preoperative step-counts. Three trajectories (high, moderate and low recovery) were identified for both absolute and relative step-counts. For\n                    <jats:italic>absolute<\/jats:italic>\n                    steps, the \u201chigh recovery\u201d group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200930, 37%) began with a median of 991 steps [IQR 1,335] at Week1 and achieved a median of 6,606 steps [IQR 2,940] by Week6. This compares to the \u201cmoderate\u201d group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200924, 29%) who improved from 360 steps [IQR 481] at Week1 to 3,739 steps [IQR 1,918] at Week6, and the \u201clow\u201d group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200928, 34%) who increased from 29 steps [IQR 176] at Week1 to 1,452 steps [IQR 1,504] by Week6. For\n                    <jats:italic>relative<\/jats:italic>\n                    steps, the \u201chigh recovery\u201d group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200939, 47%) reached 92% [IQR 29%] of their preoperative step-count at Week6, compared with 64% [IQR 25%] in the \u201cmoderate\u201d group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200926, 32%) and 31% [IQR 7%] in the \u201clow\u201d group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200917, 21%). Patients in the high recovery trajectories reported less pain, better knee function (OKS) and better health status at six weeks versus low recovery trajectories. Membership of the high trajectories was more likely in those with higher preoperative step-count and for those managed with UKR. Patients with lower preoperative step-count were unlikely to achieve high absolute step-count and less likely to achieve high- or moderate-relative recovery trajectories versus those with a higher preoperative step-count. One in three individuals regained preoperative step-count by six weeks, with heterogeneity in recovery patterns. Greater recovery was associated with higher preoperative step-count and UKR procedures.\n                  <\/jats:p>","DOI":"10.1007\/s00296-026-06135-y","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T01:31:53Z","timestamp":1780536713000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Step count recovery patterns in the first six weeks after knee replacement in individuals with knee osteoarthritis: a secondary analysis of a prospective observational cohort study using wrist-worn accelerometry"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4520-7019","authenticated-orcid":false,"given":"Ayobami E.","family":"Olanrewaju","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0963-9260","authenticated-orcid":false,"given":"Emma","family":"Pritchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7028-0944","authenticated-orcid":false,"given":"Shuai","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4258-5866","authenticated-orcid":false,"given":"Andrew J.","family":"Price","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1840-0451","authenticated-orcid":false,"given":"Aiden","family":"Doherty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0929-436X","authenticated-orcid":false,"given":"Sabine N.","family":"van der Veer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8117-9193","authenticated-orcid":false,"given":"David C.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3603-8062","authenticated-orcid":false,"given":"Scott R.","family":"Small","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9624-0791","authenticated-orcid":false,"given":"Stephanie R.","family":"Filbay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5881-4857","authenticated-orcid":false,"given":"William G.","family":"Dixon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"6135_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41572-025-00594-6","volume":"11","author":"S Tang","year":"2025","unstructured":"Tang S, Zhang C, Oo WM, Fu K, Risberg MA, Bierma-Zeinstra SM et al (2025) Osteoarthr Nat Rev Dis Primers Nat Publishing Group 11:1\u201322. https:\/\/doi.org\/10.1038\/s41572-025-00594-6","journal-title":"Osteoarthr Nat Rev Dis Primers Nat Publishing Group"},{"key":"6135_CR2","doi-asserted-by":"publisher","first-page":"2189","DOI":"10.2147\/JPR.S154002","volume":"11","author":"JC Mora","year":"2018","unstructured":"Mora JC, Przkora R, Cruz-Almeida Y (2018) Knee osteoarthritis: pathophysiology and current treatment modalities. J Pain Res 11:2189\u20132196. https:\/\/doi.org\/10.2147\/JPR.S154002","journal-title":"J Pain Res"},{"key":"6135_CR3","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1007\/s11136-019-02381-9","volume":"29","author":"S Smith","year":"2020","unstructured":"Smith S, Alvand A, Locock L, Ryan S, Smith J, Bayliss L et al (2020) Partial or total knee replacement? Identifying patients\u2019 information needs on knee replacement surgery: a qualitative study to inform a decision aid. Qual Life Res 29:999\u20131011. https:\/\/doi.org\/10.1007\/s11136-019-02381-9","journal-title":"Qual Life Res"},{"key":"6135_CR4","doi-asserted-by":"publisher","first-page":"1672","DOI":"10.1016\/S0140-6736(18)32344-4","volume":"392","author":"AJ Price","year":"2018","unstructured":"Price AJ, Alvand A, Troelsen A, Katz JN, Hooper G, Gray A et al (2018) Knee replacement. Lancet 392:1672\u20131682. https:\/\/doi.org\/10.1016\/S0140-6736(18)32344-4","journal-title":"Lancet"},{"key":"6135_CR5","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1016\/S0140-6736(11)60752-6","volume":"379","author":"AJ Carr","year":"2012","unstructured":"Carr AJ, Robertsson O, Graves S, Price AJ, Arden NK, Judge A et al (2012) Knee replacement. Lancet 379:1331\u20131340. https:\/\/doi.org\/10.1016\/S0140-6736(11)60752-6","journal-title":"Lancet"},{"key":"6135_CR6","doi-asserted-by":"publisher","unstructured":"Ghomrawi HMK, Lee L (Yuo-yu), Nwachukwu BU, Jain D, Wright T, Padgett D et al (2020) Preoperative Expectations Associated With Postoperative Dissatisfaction After Total Knee Arthroplasty: A Cohort Study. J Am Acad Orthop Surg. ;28:e145\u201350. https:\/\/doi.org\/10.5435\/JAAOS-D-18-00785","DOI":"10.5435\/JAAOS-D-18-00785"},{"key":"6135_CR7","doi-asserted-by":"publisher","first-page":"2213","DOI":"10.1007\/s00402-023-05136-x","volume":"144","author":"C Khatri","year":"2024","unstructured":"Khatri C, Ahmed I, Dhaif F, Rodrigues J, Underwood M, Davis ET et al (2024) What\u2019s important for recovery after a total knee replacement? A systematic review of mixed methods studies. Arch Orthop Trauma Surg 144:2213\u20132221. https:\/\/doi.org\/10.1007\/s00402-023-05136-x","journal-title":"Arch Orthop Trauma Surg"},{"key":"6135_CR8","doi-asserted-by":"publisher","unstructured":"Lenguerrand E, Wylde V, Gooberman-Hill R, Sayers A, Brunton L, Beswick AD et al (2016) Trajectories of Pain and Function after Primary Hip and Knee Arthroplasty: The ADAPT Cohort Study. Lucia A, editor. PLoS ONE. ;11:e0149306. https:\/\/doi.org\/10.1371\/journal.pone.0149306","DOI":"10.1371\/journal.pone.0149306"},{"key":"6135_CR9","doi-asserted-by":"publisher","first-page":"14388","DOI":"10.1038\/s41598-020-71277-3","volume":"10","author":"S Repky","year":"2020","unstructured":"Repky S, B\u00fcchele G, G\u00fcnther K-P, Huch K, Brenner H, St\u00fcrmer T et al (2020) Five years\u2019 trajectories of functionality and pain in patients after hip or knee replacement and association with long-term patient survival. Sci Rep 10:14388. https:\/\/doi.org\/10.1038\/s41598-020-71277-3","journal-title":"Sci Rep"},{"key":"6135_CR10","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1186\/s12891-021-04037-7","volume":"22","author":"KEM Harmelink","year":"2021","unstructured":"Harmelink KEM, Dandis R, der Van der Wees PJPJ, Zeegers AVCM, der Sanden MWN, Staal JB (2021) Recovery trajectories over six weeks in patients selected for a high-intensity physiotherapy program after Total knee Arthroplasty: a latent class analysis. BMC Musculoskelet Disord 22:179. https:\/\/doi.org\/10.1186\/s12891-021-04037-7","journal-title":"BMC Musculoskelet Disord"},{"key":"6135_CR11","doi-asserted-by":"publisher","first-page":"708","DOI":"10.3109\/17453674.2015.1081356","volume":"86","author":"JC Van Egmond","year":"2015","unstructured":"Van Egmond JC, Verburg H, Mathijssen NMC (2015) The first 6 weeks of recovery after total knee arthroplasty with fast track. Acta Orthop 86:708\u2013713. https:\/\/doi.org\/10.3109\/17453674.2015.1081356","journal-title":"Acta Orthop"},{"key":"6135_CR12","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/1471-2474-13-116","volume":"13","author":"I Papakostidou","year":"2012","unstructured":"Papakostidou I, Dailiana ZH, Papapolychroniou T, Liaropoulos L, Zintzaras E, Karachalios TS et al (2012) Factors affecting the quality of life after total knee arthroplasties: a prospective study. BMC Musculoskelet Disord 13:116. https:\/\/doi.org\/10.1186\/1471-2474-13-116","journal-title":"BMC Musculoskelet Disord"},{"key":"6135_CR13","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1007\/s00402-024-05710-x","volume":"145","author":"M Terradas-Monllor","year":"2024","unstructured":"Terradas-Monllor M, Rierola-Fochs S, Merchan-Baeza JA, Par\u00e9s-Martinez C, Font-Jutgl\u00e0 C, Hern\u00e1ndez-Hermoso JA et al (2024) Comparison of pain, functional and psychological trajectories between total and unicompartmental knee arthroplasties: secondary analysis of a 6-month prospective observational study. Arch Orthop Trauma Surg 145:32. https:\/\/doi.org\/10.1007\/s00402-024-05710-x","journal-title":"Arch Orthop Trauma Surg"},{"key":"6135_CR14","doi-asserted-by":"publisher","first-page":"101175","DOI":"10.1016\/j.ijotn.2025.101175","volume":"57","author":"D Wathsuleelanond","year":"2025","unstructured":"Wathsuleelanond D, Youngcharoen P, Chaiviboontham S (2025) Post-operative outcomes among knee osteoarthritis patients undergoing simultaneous bilateral total knee arthroplasty. Int J Orthop Trauma Nurs 57:101175. https:\/\/doi.org\/10.1016\/j.ijotn.2025.101175","journal-title":"Int J Orthop Trauma Nurs"},{"key":"6135_CR15","doi-asserted-by":"publisher","first-page":"5506809","DOI":"10.1155\/2021\/5506809","volume":"2021","author":"Y Al Thaher","year":"2021","unstructured":"Al Thaher Y, Alfuqaha OA, Dweidari A (2021) Health-Related Quality of Life and Outcome after Total Knee Replacement: Results from a Cross-Sectional Survey in Jordan. Adv Orthop 2021:5506809. https:\/\/doi.org\/10.1155\/2021\/5506809","journal-title":"Adv Orthop"},{"key":"6135_CR16","doi-asserted-by":"publisher","unstructured":"Pasqualini I, Emara AK, Rullan PJ, Pan XK, Simmons HL, Molloy RM et al (2023) Return to Sports and Return to Work After Total Knee Arthroplasty A Systematic Review and Meta-Analysis. JBJS REVIEWS 11. https:\/\/doi.org\/10.2106\/JBJS.RVW.22.00250","DOI":"10.2106\/JBJS.RVW.22.00250"},{"key":"6135_CR17","doi-asserted-by":"publisher","first-page":"2059","DOI":"10.1007\/s00296-015-3311-4","volume":"35","author":"C Tilbury","year":"2015","unstructured":"Tilbury C, Leichtenberg CS, Tordoir RL, Holtslag MJ, Verdegaal SHM, Kroon HM et al (2015) Return to work after total hip and knee arthroplasty: results from a clinical study. Rheumatol Int 35:2059\u20132067. https:\/\/doi.org\/10.1007\/s00296-015-3311-4","journal-title":"Rheumatol Int"},{"key":"6135_CR18","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/j.knee.2019.11.011","volume":"27","author":"LJ Kleeblad","year":"2020","unstructured":"Kleeblad LJ, Strickland SM, Nwachukwu BU, Kerkhoffs G, Pearle AD (2020) Satisfaction with return to sports after unicompartmental knee arthroplasty and what type of sports are patients doing. Knee 27:509\u2013517. 20200108th edn.https:\/\/doi.org\/10.1016\/j.knee.2019.11.011","journal-title":"Knee"},{"key":"6135_CR19","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1007\/s00167-020-05969-8","volume":"29","author":"JC van Egmond","year":"2021","unstructured":"van Egmond JC, Hesseling B, Melles M, Vehmeijer SBW, van Steenbergen LN, Mathijssen NMC et al (2021) Three distinct recovery patterns following primary total knee arthroplasty: dutch arthroplasty register study of 809 patients. Knee Surg Sports Traumatol Arthrosc 29:529\u2013539. https:\/\/doi.org\/10.1007\/s00167-020-05969-8","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"6135_CR20","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.2106\/00004623-200108000-00003","volume":"83","author":"EA Lingard","year":"2001","unstructured":"Lingard EA, Wright EA, Sledge CB, Kinemax Outcomes Group (2001) Pitfalls of using patient recall to derive preoperative status in outcome studies of total knee arthroplasty. J Bone Joint Surg Am 83:1149\u20131156. https:\/\/doi.org\/10.2106\/00004623-200108000-00003","journal-title":"J Bone Joint Surg Am"},{"key":"6135_CR21","doi-asserted-by":"publisher","first-page":"2259","DOI":"10.1161\/01.cir.0000435708.67487.da","volume":"128","author":"SJ Strath","year":"2013","unstructured":"Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA et al (2013) Guide to the Assessment of Physical Activity: Clinical and Research Applications. Circulation Am Heart Association 128:2259\u20132279. https:\/\/doi.org\/10.1161\/01.cir.0000435708.67487.da","journal-title":"Circulation Am Heart Association"},{"issue":"4","key":"6135_CR22","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.arth.2019.10.016","volume":"35","author":"E Frimpong","year":"2020","unstructured":"Frimpong E, van der Jagt DR, Mokete L, Pietrzak J, Kaoje YS, Smith A et al (2020) Improvements in Objectively Measured Activity Behaviors Do Not Correlate With Improvements in Patient-Reported Outcome Measures Following Total Knee Arthroplasty. J Arthroplasty Elsevier 35(4):712\u2013719e. https:\/\/doi.org\/10.1016\/j.arth.2019.10.016","journal-title":"J Arthroplasty Elsevier"},{"key":"6135_CR23","doi-asserted-by":"publisher","first-page":"2196","DOI":"10.1007\/s00167-018-4987-2","volume":"27","author":"E Frimpong","year":"2019","unstructured":"Frimpong E, McVeigh JA, van der Jagt D, Mokete L, Kaoje YS, Tikly M et al (2019) Light intensity physical activity increases and sedentary behavior decreases following total knee arthroplasty in patients with osteoarthritis. Knee Surg Sports Traumatol Arthrosc 27:2196\u20132205. https:\/\/doi.org\/10.1007\/s00167-018-4987-2","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"6135_CR24","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.medengphy.2017.10.007","volume":"51","author":"J Twiggs","year":"2018","unstructured":"Twiggs J, Salmon L, Kolos E, Bogue E, Miles B, Roe J (2018) Measurement of physical activity in the pre- and early post-operative period after total knee arthroplasty for Osteoarthritis using a Fitbit Flex device. Med Eng Phys 51:31\u201340. https:\/\/doi.org\/10.1016\/j.medengphy.2017.10.007","journal-title":"Med Eng Phys"},{"key":"6135_CR25","doi-asserted-by":"publisher","first-page":"2790","DOI":"10.1002\/jor.23596","volume":"35","author":"NA Cooper","year":"2017","unstructured":"Cooper NA, Rakel BA, Zimmerman B, Tonelli SM, Herr KA, Clark CR et al (2017) Predictors of multidimensional functional outcomes after total knee arthroplasty. J Orthop Res 35:2790\u20132798. https:\/\/doi.org\/10.1002\/jor.23596","journal-title":"J Orthop Res"},{"key":"6135_CR26","doi-asserted-by":"publisher","unstructured":"Bolander RP, Mangal RK, Pierce AG, Stulberg SD, D\u2019Apuzzo MR, Hernandez VH (2024) Normative Values for Daily Functional Recovery Patterns Following Total Knee Arthroplasty. The Journal of Arthroplasty [Internet]. Elsevier; [cited 2024 June 24];0. https:\/\/doi.org\/10.1016\/j.arth.2024.05.071","DOI":"10.1016\/j.arth.2024.05.071"},{"key":"6135_CR27","doi-asserted-by":"publisher","unstructured":"Bolander RP, Pierce AG, Mangal RK, Hernandez VH, Stulberg SD Characterization of the Relative Change in Objective and Subjective Metrics by Baselining Patients Who Have Wearable Technology Before Total Knee Arthroplasty. The Journal of Arthroplasty [Internet]. 2024 [cited 2024 Apr 30]; https:\/\/doi.org\/10.1016\/j.arth.2024.04.001","DOI":"10.1016\/j.arth.2024.04.001"},{"key":"6135_CR28","doi-asserted-by":"publisher","first-page":"S162","DOI":"10.1016\/j.arth.2017.02.058","volume":"32","author":"MP Crizer","year":"2017","unstructured":"Crizer MP, Kazarian GS, Fleischman AN, Lonner JH, Maltenfort MG, Chen AF (2017) Stepping Toward Objective Outcomes: A Prospective Analysis of Step Count After Total Joint Arthroplasty. J Arthroplast 32:S162\u2013S165. https:\/\/doi.org\/10.1016\/j.arth.2017.02.058","journal-title":"J Arthroplast"},{"key":"6135_CR29","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.bjpt.2019.12.002","volume":"25","author":"J Lebleu","year":"2021","unstructured":"Lebleu J, Poilvache H, Mahaudens P, De Ridder R, Detrembleur C (2021) Predicting physical activity recovery after hip and knee arthroplasty? A longitudinal cohort study. Braz J Phys Ther 25:30\u201339. https:\/\/doi.org\/10.1016\/j.bjpt.2019.12.002","journal-title":"Braz J Phys Ther"},{"key":"6135_CR30","doi-asserted-by":"publisher","first-page":"2253","DOI":"10.1016\/j.arth.2019.05.021","volume":"34","author":"PN Ramkumar","year":"2019","unstructured":"Ramkumar PN, Haeberle HS, Ramanathan D, Cantrell WA, Navarro SM, Mont MA et al (2019) Remote Patient Monitoring Using Mobile Health for Total Knee Arthroplasty: Validation of a Wearable and Machine Learning-Based Surveillance Platform. J Arthroplasty 34:2253\u20132259. https:\/\/doi.org\/10.1016\/j.arth.2019.05.021","journal-title":"J Arthroplasty"},{"key":"6135_CR31","doi-asserted-by":"publisher","DOI":"10.60118\/001c.72644","author":"RJ Mobbs","year":"2023","unstructured":"Mobbs RJ, Amin T, Stulberg SD, Kerina JM, Hernandez V, Bolander R (2023) Remote Monitoring using Wearable Technology after Knee Arthroplasty Using a Joint-Specific Wearable Device: A Prospective Cohort Study of 435 patients with 6 week follow up. J Orthop Experience Innov [Internet] J Orthop Experience Innov. [cited 2024 July 18];4 https:\/\/doi.org\/10.60118\/001c.72644","journal-title":"J Orthop Experience Innov [Internet] J Orthop Experience Innov"},{"key":"6135_CR32","doi-asserted-by":"publisher","first-page":"S94","DOI":"10.1016\/j.arth.2023.03.060","volume":"38","author":"JC Christensen","year":"2023","unstructured":"Christensen JC, Blackburn BE, Anderson LA, Gililland JM, Peters CL, Archibeck MJ et al (2023) Recovery Curve for Patient Reported Outcomes and Objective Physical Activity After Primary Total Knee Arthroplasty-A Multicenter Study Using Wearable Technology. J Arthroplasty 38:S94\u2013102. https:\/\/doi.org\/10.1016\/j.arth.2023.03.060","journal-title":"J Arthroplasty"},{"key":"6135_CR33","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1007\/s11420-019-09746-3","volume":"16","author":"S Lyman","year":"2020","unstructured":"Lyman S, Hidaka C, Fields K, Islam W, Mayman D (2020) Monitoring Patient Recovery after THA or TKA using Mobile Technology. HSS Journal\u00ae SAGE Publications 16:358\u2013365. https:\/\/doi.org\/10.1007\/s11420-019-09746-3","journal-title":"HSS Journal\u00ae SAGE Publications"},{"key":"6135_CR34","doi-asserted-by":"publisher","first-page":"78","DOI":"10.2519\/josptopen.2023.0011","volume":"1","author":"V Duong","year":"2023","unstructured":"Duong V, Dennis S, Ferreira ML, Nicolson PJA, Robbins SR, Venkatesha V et al (2023) Three Distinct Step Count Trajectories Identified at 3-Months After Total Knee Replacement: An Exploratory Cohort Study. JOSPT Open J Orthop Sports Phys Therapy 1:78\u201385. https:\/\/doi.org\/10.2519\/josptopen.2023.0011","journal-title":"JOSPT Open J Orthop Sports Phys Therapy"},{"key":"6135_CR35","unstructured":"Small SR (2022) Identifying the trajectory of normal recovery following knee arthroplasty via physical activity monitoring [Internet] [http:\/\/purl.org\/dc\/dcmitype\/Text. University of Oxford; [cited 2025 Nov 26]. https:\/\/ora.ox.ac.uk\/objects\/uuid:5a9e41bf-9da1-4e5c-951b-aa2fc9a52cca. Accessed 26 Nov 2025"},{"key":"6135_CR36","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1007\/s40279-016-0663-1","volume":"47","author":"DR Bassett","year":"2017","unstructured":"Bassett DR, Toth LP, LaMunion SR, Crouter SE (2017) Step Counting: A Review of Measurement Considerations and Health-Related Applications. Sports Med 47:1303\u20131315. https:\/\/doi.org\/10.1007\/s40279-016-0663-1","journal-title":"Sports Med"},{"key":"6135_CR37","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1302\/0301-620x.80b1.7859","volume":"80","author":"J Dawson","year":"1998","unstructured":"Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 80:63\u201369. https:\/\/doi.org\/10.1302\/0301-620x.80b1.7859","journal-title":"J Bone Joint Surg Br"},{"key":"6135_CR38","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1186\/s12891-017-1405-8","volume":"18","author":"A Reito","year":"2017","unstructured":"Reito A, J\u00e4rvist\u00f6 A, J\u00e4msen E, Skytt\u00e4 E, Remes V, Huhtala H et al (2017) Translation and validation of the 12-item Oxford knee score for use in Finland. BMC Musculoskelet Disord 18:74. https:\/\/doi.org\/10.1186\/s12891-017-1405-8","journal-title":"BMC Musculoskelet Disord"},{"key":"6135_CR39","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/j.otsr.2012.03.004","volume":"98","author":"J-Y Jenny","year":"2012","unstructured":"Jenny J-Y, Diesinger Y (2012) The Oxford Knee Score: Compared performance before and after knee replacement. Orthop Traumatology: Surg Res 98:409\u2013412. https:\/\/doi.org\/10.1016\/j.otsr.2012.03.004","journal-title":"Orthop Traumatology: Surg Res"},{"key":"6135_CR40","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-47622-9_1","author":"PDN Devlin","year":"2020","unstructured":"Devlin PDN, Parkin D, Janssen B (2020) An Introduction to EQ-5D Instruments and Their Applications. Springer. [cited 2025 Oct 30]https:\/\/doi.org\/10.1007\/978-3-030-47622-9_1. Methods for Analysing and Reporting EQ-5D Data [Internet] [Internet]"},{"key":"6135_CR41","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1302\/2046-3758.119.BJR-2022-0054.R1","volume":"11","author":"LZ Yapp","year":"2022","unstructured":"Yapp LZ, Scott CEH, Howie CR, MacDonald DJ, Simpson AHRW, Clement ND (2022) Meaningful values of the EQ-5D-3L in patients undergoing primary knee arthroplasty. Bone Joint Res Bone Joint 11:619\u2013628. https:\/\/doi.org\/10.1302\/2046-3758.119.BJR-2022-0054.R1","journal-title":"Bone Joint Res Bone Joint"},{"key":"6135_CR42","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12955-023-02126-w","volume":"21","author":"D-Y Lin","year":"2023","unstructured":"Lin D-Y, Cheok TS, Kaambwa B, Samson AJ, Morrison C, Chan T et al (2023) Evaluation of the EQ-5D-5L, EQ-VAS stand-alone component and Oxford knee score in the Australian knee arthroplasty population utilising minimally important difference, concurrent validity, predictive validity and responsiveness. Health Qual Life Outcomes 21:41. https:\/\/doi.org\/10.1186\/s12955-023-02126-w","journal-title":"Health Qual Life Outcomes"},{"key":"6135_CR43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v078.i02","volume":"78","author":"C Proust-Lima","year":"2017","unstructured":"Proust-Lima C, Philipps V, Liquet B (2017) Estimation of Extended Mixed Models Using Latent Classes and Latent Processes: The R Package lcmm. J Stat Softw 78:1\u201356. https:\/\/doi.org\/10.18637\/jss.v078.i02","journal-title":"J Stat Softw"},{"key":"6135_CR44","doi-asserted-by":"publisher","unstructured":"Proust-Lima C, Philipps V, Diakite A, Liquet B, Genz A, Burkardt J, lcmm Extended Mixed Models Using Latent Classes and Latent Processes [Internet]. 2025 [cited 2025 Dec 11]. p. 2.2.2. https:\/\/doi.org\/10.32614\/CRAN.package.lcmm","DOI":"10.32614\/CRAN.package.lcmm"},{"key":"6135_CR45","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/B978-0-12-417235-7.00002-0","volume-title":"Handbook of Aging and the Social Sciences (Eighth Edition) [Internet]","author":"SM Lynch","year":"2016","unstructured":"Lynch SM, Taylor MG (2016) Chapter 2 - Trajectory Models for Aging Research. In: George LK, Ferraro KF (eds) Handbook of Aging and the Social Sciences (Eighth Edition) [Internet]. Academic, San Diego, pp 23\u201351. [cited 2025 Oct 30] https:\/\/doi.org\/10.1016\/B978-0-12-417235-7.00002-0"},{"key":"6135_CR46","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1186\/s12874-018-0540-8","volume":"18","author":"M Giacalone","year":"2018","unstructured":"Giacalone M, Agata Z, Cozzucoli PC, Alibrandi A (2018) Bonferroni-Holm and permutation tests to compare health data: methodological and applicative issues. BMC Med Res Methodol 18:81. https:\/\/doi.org\/10.1186\/s12874-018-0540-8","journal-title":"BMC Med Res Methodol"},{"key":"6135_CR47","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.3390\/s24041163","volume":"24","author":"J Lebleu","year":"2024","unstructured":"Lebleu J, Daniels K, Pauwels A, Dekimpe L, Mapinduzi J, Poilvache H et al (2024) Incorporating Wearable Technology for Enhanced Rehabilitation Monitoring after Hip and Knee Replacement. Sens Multidisciplinary Digit Publishing Inst 24:1163. https:\/\/doi.org\/10.3390\/s24041163","journal-title":"Sens Multidisciplinary Digit Publishing Inst"},{"key":"6135_CR48","doi-asserted-by":"publisher","first-page":"S84","DOI":"10.1016\/j.arth.2025.03.061","volume":"40","author":"DN Kugelman","year":"2025","unstructured":"Kugelman DN, Wu KA, Goel RK, Dilbone ES, Ryan SP, Bolognesi MP et al (2025) Comparing Functional Recovery Between Total and Unicompartmental Knee Arthroplasty: A Prospective Health Kit Study. J Arthroplasty 40:S84\u2013S87. https:\/\/doi.org\/10.1016\/j.arth.2025.03.061","journal-title":"J Arthroplasty"},{"key":"6135_CR49","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1370862","author":"NL Barclay","year":"2024","unstructured":"Barclay NL, Pineda Moncus\u00ed M, J\u00f6dicke AM, Prieto-Alhambra D, Ravent\u00f3s B, Newby D et al (2024) The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study. Front Oncol [Internet] Front. [cited 2025 Oct 24];14 https:\/\/doi.org\/10.3389\/fonc.2024.1370862","journal-title":"Front Oncol [Internet] Front"},{"key":"6135_CR50","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000003478","author":"SR Small","year":"2023","unstructured":"Small SR, Chan S, Walmsley R, von Fritsch L, Acquah A, Mertes G et al (2023) Self-Supervised Machine Learning to Characterise Step Counts from Wrist-Worn Accelerometers in the UK Biobank. Med Sci Sports Exerc https:\/\/doi.org\/10.1249\/MSS.0000000000003478","journal-title":"Med Sci Sports Exerc"},{"key":"6135_CR51","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1016\/j.arth.2012.10.018","volume":"28","author":"P Levinger","year":"2013","unstructured":"Levinger P, Menz HB, Morrow AD, Feller JA, Bartlett JR, Bergman NR (2013) Lower Limb Biomechanics in Individuals With Knee Osteoarthritis Before and After Total Knee Arthroplasty Surgery. J Arthroplast 28:994\u2013999. https:\/\/doi.org\/10.1016\/j.arth.2012.10.018","journal-title":"J Arthroplast"},{"key":"6135_CR52","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1186\/s13018-024-04892-9","volume":"19","author":"P Kooner","year":"2024","unstructured":"Kooner P, Baskaran S, Gibbs V, Wein S, Dimentberg R, Albers A (2024) Commercially available activity monitors such as the fitbit charge and apple watch show poor validity in patients with gait aids after total knee arthroplasty. J Orthop Surg Res 19:404. https:\/\/doi.org\/10.1186\/s13018-024-04892-9","journal-title":"J Orthop Surg Res"},{"key":"6135_CR53","doi-asserted-by":"publisher","unstructured":"Tan X, Dierker L, Rose J, Li R, The Tobacco Etiology Research Network (2011). How Spacing of Data Collection May Impact Estimates of Substance Use Trajectories. Substance Use & Misuse. Taylor & Francis; ;46:758\u2013768. https:\/\/doi.org\/10.3109\/10826084.2010.537731","DOI":"10.3109\/10826084.2010.537731"}],"container-title":["Rheumatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-026-06135-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00296-026-06135-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-026-06135-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:39:19Z","timestamp":1783525159000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00296-026-06135-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":53,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["6135"],"URL":"https:\/\/doi.org\/10.1007\/s00296-026-06135-y","relation":{"references":[{"id-type":"doi","id":"10.1007\/978-3-030-47622-9_1","asserted-by":"subject"}]},"ISSN":["1437-160X"],"issn-type":[{"value":"1437-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]},"assertion":[{"value":"23 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"AD\u2019s research team is supported by a range of industry-funded research grants from Swiss Re, GSK, Boehringer Ingelheim, and Google. All other authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The primary study was reviewed by the South West-Frenchay Research Ethics Committee (reference: 19\/SW\/0151) and received initial approval from the NHS Health Research Authority on 15 October 2019, with subsequent approved amendments on 16 January 2020 and 16 May 2020. The study protocol was registered on ClinicalTrials.gov under identifier NCT04240769 (\n                      \n                      ). The study was conducted in line with the 1964 Helsinki Declaration and its seventh revision in 2013. Data for this secondary analysis were accessed in anonymised form from the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, and with permission from their data governance team.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Participants provided written informed consent approved by the South West-Frenchay Research Ethics Committee (reference: 19\/SW\/0151).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}],"article-number":"131"}}