Background. The purpose of this study is to evaluate the early outcomes with the use of a smartphone-based exercise and educational platform after primary total hip arthroplasty compared to a standard of care control group. Methods. A multicenter prospective randomized control trial was conducted evaluating the use of the mymobility smartphone-based care platform for primary total hip arthroplasty (THA). Patients randomized to the control group (198 patients) received the respective institution's standard of care. Those randomized to mymobility treatment group (167 patients) were provided an Apple Watch and mymobility smartphone application. The application provides pre and postoperative educational content, video directed exercise programs as well as tracks the patient's activity. Patients in the treatment group were not initially prescribed physical therapy, but could be if their surgeon deemed it necessary. Early outcomes assessed included 90-day hip range of motion, HOOS JR scores, 30-day single leg stance (SLS) and time up and go (TUG) test. We also evaluated PT utilization, THA complications associated with readmissions, ER visits not associated with readmissions, urgent care (non standard of care) visits, and physician office visits. Outcome scores include HOOS-Jr, EQ-5D-5L, single stance (SLS), Timed up and go (TUG). Satisfaction scores for the procedure and the mymobility study group were also recorded. Results. The control group was significantly younger by 3.0 years (p=0.007), but no significant difference between groups in BMI, gender or preoperative diagnosis. Postoperative PT utilization was statistically lower in the mymobility group. (P=.001). There were no statistically significant differences in complications, readmissions, or office visits. The 90-day outcomes showed no significant differences in hip flexion between controls (101.3±10.9) and mymobility (99.8 ±12) (p=0.34). HOOS JR scores were not significantly different between control group (84 ±14.5) and mymobility group (81 ±13) (p=0.15). Mean 30-day SLS time was 22.5 ±20 sec in the control group and 19.8 ±19 sec in the mymobility group (p=0.25). Mean TUG time was 14.1 ±27.4 sec for control group and 16.1 ±43.3 sec for my mobility group (p=0.7). Conclusion. The use of the mymobility care platform demonstrated similar early outcomes to traditional care models. This study showed a significant decrease in PTA utilization. Initial findings demonstrated non inferiority of the mymobility platform with regards to complications, readmissions, emergency room and urgent care visits. Strengths of this study include randomized, multicentered study design. Both groups were balanced except for age. Weakness of this study is the lack of preoperative functional testing which may influence postoperative single stance. This technology allows patients to rehabilitate on a more flexible schedule, avoid unnecessary healthcare visits as well as potentially decrease overall healthcare costs

Aims

The volume of ambulatory total hip arthroplasty (THA) procedures is increasing due to the emphasis on value-based care. The purpose of the study is to identify the causes for failed same-day discharge (SDD) and perioperative factors leading to failed SDD.

Aims

The aim of this study was to estimate time to arthroplasty among patients with hip and knee osteoarthritis (OA), and to identify factors at enrolment to first-line intervention that are prognostic for progression to surgery.

Aims

The purpose of this study is to evaluate early outcomes with the use of a smartphone-based exercise and educational care management system after total hip arthroplasty (THA) and demonstrate decreased use of in-person physiotherapy (PT).

Objectives

To quantify and compare peri-acetabular bone mineral density (BMD) between a monoblock acetabular component using a metal-on-metal (MoM) bearing and a modular titanium shell with a polyethylene (PE) insert. The secondary outcome was to measure patient-reported clinical function.

The major advantage of hip resurfacing is the decreased amount of bone resection compared with a standard total hip replacement. Fracture of the femoral neck is the most common early complication and poor bone quality is a major risk factor. We undertook a prospective consecutive case control study examining the effect of bone mineral density changes in patients undergoing hip resurfacing surgery. A total of 423 patients were recruited with a mean age of 54 years (24 to 87). Recruitment for this study was dependent on pre-operative bilateral femoral bone mineral density results not being osteoporotic. The operated and non-operated hips were assessed. Bone mineral density studies were repeated over a two-year period. The results showed no significant deterioration in the bone mineral density in the superolateral region in the femoral neck, during that period.

These findings were in the presence of a markedly increased level of physical activity, as measured by the short-form 36 health survey physical function score.