Remote Follow-Up Using Smartphone Apps, Telemedicine, and Wearable Activity Sensors After Joint Replacement: A Narrative Review

Abstract

Digital health tools such as smartphone applications, telemedicine platforms, wearable activity sensors, and emerging smart implants are positively influencing postoperative follow-up after joint replacement. This narrative review synthesizes recent advances and evidence across these modalities. Smartphone apps consistently improve patient engagement, adherence, pain management, and functional recovery, while enabling scalable data capture. Wearables provide objective, continuous measures of mobility and range of motion and have shown acceptable accuracy in arthroplasty populations. Combined app-plus-sensor programs, including self-directed rehabilitation, achieve clinical outcomes comparable to standard care in randomized trials and can reduce costs and in-person visits. Telemedicine and home-based telerehabilitation demonstrate noninferiority to face-to-face physiotherapy for total joint arthroplasty, with high patient satisfaction and logistical advantages. Smart implants, though earlier in clinical adoption, yield unique biomechanical insights that may personalize rehabilitation and enable early detection of complications. Key challenges include heterogeneous study designs and metrics, device placement-dependent accuracy, digital literacy and connectivity barriers (especially among older adults or rural patients), data security and regulatory considerations, and technical constraints for implant power and wireless communication. Overall, remote follow-up using apps and wearables is a credible adjunct, or alternative, to conventional pathways after joint replacement; scaling impact will require standardized outcomes, interoperability, robust privacy safeguards, and prospective trials that link digital signals to meaningful clinical endpoints.