From One-Size-Fits-All to Data-Driven Recovery: A Narrative Review of Wearable Technologies Toward Personalized Rehabilitation After Total Hip and Knee Arthroplasty.

Abstract

Background/Objectives: Commercial wearables are increasingly used after total hip and knee arthroplasty (THA/TKA) to record activity and gait outside the clinic and may help tailor recovery pathways. We reviewed the evidence on commercial devices, digital phenotyping, and data-informed rehabilitation after arthroplasty. Methods: We performed a structured narrative search of PubMed and Google Scholar. Of 916 records, 63 duplicates were removed, 853 were screened, 245 full texts were assessed, and 76 publications were included. Findings were synthesized thematically; no formal risk-of-bias assessment or evidence grading was undertaken. Results: Recovery differed by outcome and procedure. PROMs commonly improved within 1-3 months, while gait-quality measures recovered over about 7-13 weeks after THA and 13-24 weeks after TKA. Frequency-domain gait features, sample entropy, and machine-learning models provided information beyond step counts. Tracker-based interventions most consistently increased postoperative steps when introduced early and combined with behavior-change support, while digital rehabilitation was generally non-inferior to conventional rehabilitation. Wrist-worn consumer devices remained inaccurate with gait aids, compliance definitions varied, and higher step counts did not consistently correspond to better PROMs. Conclusions: Commercial wearables already support phenotyping and remote follow-up of individual recovery trajectories, but evidence for fully adaptive rehabilitation remains limited.