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Assistive Mobility Devices in Primary Total Joint Arthroplasty: Patient Characteristics and Outcomes Across Types of
Justin J Turcotte1, Jane C Brennan1, Andrea H Johnson1
1Department of Orthopedics, Luminis Health Orthopedics, Annapolis, Maryland.
Background:
Despite the high prevalence of assistive mobility device (AD) use among the total joint arthroplasty (TJA) population, few studies have evaluated the relationship between the types of ADs used and postoperative outcomes. This study evaluated differences in baseline characteristics and outcomes of patients using various types of ADs prior to TJA.
Methods:
A retrospective review of 2,071 primary total hip arthroplasty (THA, n = 861) or total knee arthroplasty (TKA, n = 1,210) patients from 2020 to 2023 was performed. All patients completed the Patient-Reported Outcomes Measurement Information System Physical Function survey at baseline and 1-year follow-up. Univariate and multivariable statistics were used to compare baseline characteristics and outcomes between patients using a wheelchair/walker, cane/walking stick, or no AD preoperatively.
Results:
Across both THA and TKA patients, age, body mass index, and comorbidities increased as the level of AD increased. Preoperative device use was associated with longer length of stay and higher rates of skilled nursing facility discharge. Both THA and TKA AD users presented with worse baseline function and reached lower levels of function at one year postoperatively. However, THA patients using an AD were more likely to experience clinically relevant improvement in physical function at 1 year than patients not using an AD. In contrast, AD use was associated with similar or decreased rates of clinically relevant improvement postoperatively among TKA patients. Overall, over half of the patients requiring an AD preoperatively no longer used the device at 1-year follow-up.
Conclusions:
Total hip and knee arthroplasty patients requiring ADs preoperatively present with a higher risk demographic and comorbidity profile and exhibit lower levels of physical function at both baseline and one year postoperatively than nonusers. While THA AD users are more likely to experience clinically significant improvements in physical function than nonusers, TKA device users may experience similar or reduced rates of clinically significant improvement. Further study is required to examine the factors influencing functional recovery among TJA patients requiring ADs.
