Improved Walking Steadiness Following Total Hip Arthroplasty Compared to Total Knee Arthroplasty

Authors

Kevin A. Wu
David N. Kugelman, Rothman Orthopaedic InstituteFollow
Samuel Rosas
Sharrieff N. Shah
Sean P. Ryan
Samuel S. Wellman
Michael P. Bolognesi
Thorsten M. Seyler

Document Type

Article

Publication Date

8-25-2025

Comments

This article is the author's final published version in Arthroplasty Today, Volume 35, October 2025, Article number 101802.

The published version is available at https://doi.org/10.1016/j.artd.2025.101802. Copyright © 2025 The Authors.

Abstract

BACKGROUND: Total knee (TKA) and hip arthroplasty (THA) effectively treat end-stage osteoarthritis by restoring mobility and reducing pain; however, it is unclear how balance and steadiness compare between TKA and THA patients. This study utilized wearable technology to objectively compare functional recovery between TKA and THA patients.

METHODS: Two Hundred Nine patients underwent TKA (n = 152) or THA (n = 57) and were followed for 1 year. Participants wore Apple Watches with HealthKit to track daily step count, steadiness, standing duration, gait speed, and estimated 6-minute walk test distance. Data were analyzed at baseline, 6 weeks, 6 months, and 12 months postsurgery. Propensity score matching (1:1 ratio) yielded a final cohort of 110 patients (55 TKA, 55 THA). A multivariate regression analysis was conducted to evaluate the effect of THA vs TKA on steadiness, adjusting for contralateral Kellgren-Lawrence classification, age, sex, and body mass index.

RESULTS: Both groups improved mobility and endurance, with similar increases in step count, standing duration, and 6-minute walk test distance over 12 months. THA patients showed significantly greater steadiness at 6 (0.63 vs 0.49,

CONCLUSIONS: This study, the first to utilize Apple HealthKit data to compare TKA and THA recovery, found that THA patients exhibit better steadiness and balance recovery at 6 and 12 months. These findings suggest that balance-focused rehabilitation may benefit TKA patients. Wearable technology provides valuable, objective insights, enabling personalized guidance and enhancing patient outcomes.

Recommended Citation

Wu, Kevin A.; Kugelman, David N.; Rosas, Samuel; Shah, Sharrieff N.; Ryan, Sean P.; Wellman, Samuel S.; Bolognesi, Michael P.; and Seyler, Thorsten M., "Improved Walking Steadiness Following Total Hip Arthroplasty Compared to Total Knee Arthroplasty" (2025). Rothman Institute Papers. Paper 297.
https://jdc.jefferson.edu/rothman_institute/297

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English