JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) applications have become more common in healthcare, including in orthopaedics. However, for these mHealth apps to be efficient, patients should be willing to use them.

Objective:

This study evaluated the acceptability of using an mHealth app for post-operative care following total hip and knee arthroplasty.

Methods:

This pre-operative cohort study with 100 patients measured acceptability using the theoretical framework for acceptability (TFA) pre-operatively and at three months post-operation. We also measured satisfaction with app usage post-operatively using the USE questionnaire as well as PROMs pre-operatively and post-operatively using the Oxford hip and knee scores and the VAS. Patients included were 18 or older, underwent unilateral primary total hip, total knee or partial knee arthroplasty, spoke and read French or English and had a smartphone with Internet access. Participants used mymobility® (Zimmer-Biomet) in addition to standard government funded physiotherapy.

Results:

Overall result for pre-operative TFA was 4.2 ± 0.6 out of 5. When comparing TFA results for patients who filled both pre-operative and post-operative TFAs, there was a statistically significant decrease in post-operative TFAs. Subgroup analysis revealed higher levels of self-efficacy in pre-operative TFAs with university level education compared to non-university, and lower levels of acceptability in post-operative TFAs with TKA compared to THA. USE questionnaire revealed a good level of satisfaction with usage of the app and PROMs showed improvement in THA but not in TKA at average 31.2 days follow-up.

Conclusions:

There was a good level of acceptability with the use of mymobility® for the post-operative management in THA and TKA, although acceptability decreased post-operatively. Higher education was associated with higher acceptability, whereas TKA as the procedure was associated with lower acceptability. Reduction in acceptability post-operatively could signify high expectations towards the app pre-operatively, higher than expected difficulties and pain in the early post-operative period, or the need for app improvement.