Patient Needs for an Ambulant Dislocation Alert System Following Total Hip Arthroplasty

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Abstract
Introduction: One of the major complications in total hip arthroplasty (THA) is dislocation of the prosthesis. To prevent early dislocation, patients are instructed with movement restrictions. The first goal in this development is to obtain insight in the movement restrictions that are reported to have low levels of self-efficacy during activities of daily life. The second goal is to reveal the design needs for an ambulant hip dislocation alert system (HipDas) and the third goal is to explore its usability among patients. Methods: Patient-centered experiences with THA were explored by the use of a questionnaire and a semistructured focus group. The questionnaire was administered among n = 32 THA patients at 1 week preoperative and at 3 and 6 weeks postoperative. The questions addressed self-efficacy, performance and effort expectancy, and usefulness and social influence. The focus group consisted of patient journeys and scenario composition. The usability of a prototype version of the HipDas system was evaluated (n = 5). Results: Flexion of the hip >90°, bending over while sitting in a chair, and sleeping in a supine position are the restrictions that have the lowest self-efficacy. The majority of patients (>86.6%) believe that a future HipDas is useful. Focus group outcomes suggest there is a gradual decrease in the threshold for feedback. The system is preferably used in the first 6 weeks after surgery and appeared to be usable and highly clinically relevant. Discussion: HipDas is considered an interesting concept that can accelerate functional recovery of patients following THA by providing support on how to properly apply postoperative movement restrictions to prevent a dislocation.

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