Wearable Devices and Artificial Intelligence to Enhance Perioperative Care in Total Knee Arthroplasty

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Not reported — no pooled effect size available from this narrative review

• Primary Outcome: No primary outcome formally defined or quantitatively reported. The review narratively supports the potential of wearable devices to enhance perioperative TKA care across domains including activity monitoring, vital sign surveillance, rehabilitation tracking, and biochemical monitoring.

• Nnt Or Sensitivity: Not calculable from this review. No NNT, sensitivity, specificity, or hazard ratios are derivable. Individual primary studies cited within the review may contain such data but are not synthesised here.

• Confidence Interval: Not reported

Clinical Application

Feasibility is context-dependent. Consumer-grade wearables (smartwatches, fitness trackers) are widely available and relatively low-cost, but clinical-grade devices with validated accuracy for perioperative monitoring remain expensive and not universally accessible. Integration with electronic medical records, clinical workflows, and multidisciplinary rehabilitation teams requires significant infrastructure investment. Patient adherence, particularly in older TKA populations, remains a documented challenge. In Australia, wearable devices for TKA perioperative monitoring are not currently listed on the Pharmaceutical Benefits Scheme (PBS) or the Medicare Benefits Schedule (MBS) as reimbursable items. The Therapeutic Goods Administration (TGA) regulates software-based medical devices under the Software as a Medical Device (SaMD) framework, and AI-integrated wearable platforms would require TGA registration as Class IIa or higher medical devices depending on intended use. The RACGP and Australian Orthopaedic Association (AOA) have not yet issued specific guidelines on wearable device use in TKA perioperative care. The My Health Record system and national digital health strategy (Australian Digital Health Agency) provide a potential infrastructure pathway for wearable data integration. Equity considerations are significant — rural and remote patients, older Australians, and those with lower digital literacy may face disproportionate barriers to adoption. The Australian Commission on Safety and Quality in Health Care (ACSQHC) Hip and Knee Replacement Clinical Care Standard provides the current benchmark against which wearable-enhanced care should be evaluated. Adult patients undergoing elective total knee arthroplasty, particularly those with comorbidities (obesity, diabetes, cardiovascular disease) who may benefit from enhanced perioperative monitoring. Patients with digital literacy and access to compatible devices are most likely to benefit based on current evidence.

Abstract

Rapidly evolving wearable devices have the potential to transform health care delivery and enhance outcomes. Applications of wearable smart devices range from activity and motion tracking to real-time monitoring of vital signs and biochemical markers. Recent evidence provides support for the use of wearable devices in chronic disease management, rehabilitation, and perioperative care of patients with total knee arthroplasty. Data derived from these devices may enhance treatment personalization and early identification of complications. Challenges remain regarding accuracy, standardization, privacy, and patient adherence. Future advances must overcome these limitations.

References

1. 1.Dickinson, C., Piedy, E., Bronstone, A., & Dasa, V. (2026). Wearable devices and artificial intelligence to enhance perioperative care in total knee arthroplasty. Orthopedic Clinics of North America. Advance online publication. https://doi.org/10.1016/j.ocl.2026.02.001