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Background <p>Patient-reported outcome measures (PROMs) are the clinical standard for assessing recovery after total knee arthroplasty (TKA) which reflect patients’ perceived function, whereas smartwatch step counts capture real-world activity. Whether their changes align after TKA is uncertain. We therefore assessed correlations between changes in daily steps and changes in PROMs.</p> Methods <p>In this prospective single-centre cohort, 86 patients undergoing unilateral primary TKA received a consumer-grade smartwatch (Polar A370™). Daily steps and PROMs were recorded 1 month pre-operatively and at 3 and 6 months post-operatively. PROMs comprised the Oxford Knee Score (OKS; 0–48, higher&#xa0;= &#xa0;better) and the KOOS-Physical Function Short-form (KOOS-PS; 0–28, higher&#xa0;=&#xa0; worse). Change scores were computed so that positive values indicated improvement. Pearson correlations assessed associations between change in steps and change in PROMs; paired<i> t</i>-tests compared pre-operative with 6-month values.</p> Results <p>Of 96 enrolled patients, 86 (89.6%) completed the 6-month follow-up. At 6 months, functional outcomes improved substantially: OKS increased from 26.4 (6.6) to 38.4 (5.8) (<i>p</i>&#xa0;&lt;&#xa0; 0.001), and KOOS-PS decreased from 14.1 (4.3) to 9.8 (2.7) (<i>p</i>&#xa0;&lt;&#xa0; 0.001). Daily steps increased modestly from 6651 (4,294) to 7807 (4,363) (<i>p</i>&#xa0;=&#xa0; 0.008). Correlations between change in steps and change in PROMs were negligible: OKS <i>r</i>&#xa0;= &#xa0;0.055 (95% CI&#xa0;− &#xa0;0.159 to 0.264) and KOOS-PS <i>r</i>&#xa0;= &#xa0;0.071 (95% CI −&#xa0; 0.143 to 0.279).</p> Conclusions <p>Although PROMs improved markedly after TKA, they showed little correlation with smartwatch-measured step counts. Patient-reported outcomes and objective activity data reflect different aspects of recovery and should be interpreted as complementary rather than hierarchical measures.</p> <p><i>IRB approval</i>: Si COA 582/2022</p>

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Correlation between smartwatch-measured daily walking steps and patient-reported functional outcomes following total knee arthroplasty: a prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月9日

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  • Chaiwat Achawakulthep,
  • Songkran Khattiya,
  • Keerati Chareancholvanich,
  • Chaturong Pornrattanamaneewong,
  • Kit Awirotananon,
  • Rapeepat Narkbunnam

摘要

Background

Patient-reported outcome measures (PROMs) are the clinical standard for assessing recovery after total knee arthroplasty (TKA) which reflect patients’ perceived function, whereas smartwatch step counts capture real-world activity. Whether their changes align after TKA is uncertain. We therefore assessed correlations between changes in daily steps and changes in PROMs.

Methods

In this prospective single-centre cohort, 86 patients undergoing unilateral primary TKA received a consumer-grade smartwatch (Polar A370™). Daily steps and PROMs were recorded 1 month pre-operatively and at 3 and 6 months post-operatively. PROMs comprised the Oxford Knee Score (OKS; 0–48, higher =  better) and the KOOS-Physical Function Short-form (KOOS-PS; 0–28, higher =  worse). Change scores were computed so that positive values indicated improvement. Pearson correlations assessed associations between change in steps and change in PROMs; paired t-tests compared pre-operative with 6-month values.

Results

Of 96 enrolled patients, 86 (89.6%) completed the 6-month follow-up. At 6 months, functional outcomes improved substantially: OKS increased from 26.4 (6.6) to 38.4 (5.8) (p <  0.001), and KOOS-PS decreased from 14.1 (4.3) to 9.8 (2.7) (p <  0.001). Daily steps increased modestly from 6651 (4,294) to 7807 (4,363) (p =  0.008). Correlations between change in steps and change in PROMs were negligible: OKS r =  0.055 (95% CI −  0.159 to 0.264) and KOOS-PS r =  0.071 (95% CI −  0.143 to 0.279).

Conclusions

Although PROMs improved markedly after TKA, they showed little correlation with smartwatch-measured step counts. Patient-reported outcomes and objective activity data reflect different aspects of recovery and should be interpreted as complementary rather than hierarchical measures.

IRB approval: Si COA 582/2022