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

Publication ,  Journal Article
Wu, KA; Kugelman, DN; Rosas, S; Shah, SN; Ryan, SP; Wellman, SS; Bolognesi, MP; Seyler, TM
Published in: Arthroplast Today
October 2025

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, P = .031) and 12 months (0.84 vs 0.66, P = .044). Multivariate analysis confirmed that TKA was associated with lower steadiness scores. 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.

Duke Scholars

Published In

Arthroplast Today

DOI

ISSN

2352-3441

Publication Date

October 2025

Volume

35

Start / End Page

101802

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wu, K. A., Kugelman, D. N., Rosas, S., Shah, S. N., Ryan, S. P., Wellman, S. S., … Seyler, T. M. (2025). Improved Walking Steadiness Following total Hip Arthroplasty Compared to Total Knee Arthroplasty. Arthroplast Today, 35, 101802. https://doi.org/10.1016/j.artd.2025.101802
Wu, Kevin A., David N. Kugelman, Samuel Rosas, Sharrieff N. Shah, Sean P. Ryan, Samuel S. Wellman, Michael P. Bolognesi, and Thorsten M. Seyler. “Improved Walking Steadiness Following total Hip Arthroplasty Compared to Total Knee Arthroplasty.Arthroplast Today 35 (October 2025): 101802. https://doi.org/10.1016/j.artd.2025.101802.
Wu KA, Kugelman DN, Rosas S, Shah SN, Ryan SP, Wellman SS, et al. Improved Walking Steadiness Following total Hip Arthroplasty Compared to Total Knee Arthroplasty. Arthroplast Today. 2025 Oct;35:101802.
Wu, Kevin A., et al. “Improved Walking Steadiness Following total Hip Arthroplasty Compared to Total Knee Arthroplasty.Arthroplast Today, vol. 35, Oct. 2025, p. 101802. Pubmed, doi:10.1016/j.artd.2025.101802.
Wu KA, Kugelman DN, Rosas S, Shah SN, Ryan SP, Wellman SS, Bolognesi MP, Seyler TM. Improved Walking Steadiness Following total Hip Arthroplasty Compared to Total Knee Arthroplasty. Arthroplast Today. 2025 Oct;35:101802.
Journal cover image

Published In

Arthroplast Today

DOI

ISSN

2352-3441

Publication Date

October 2025

Volume

35

Start / End Page

101802

Location

United States