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Objective functional assessment in orthopedics: The emerging role of wearable technologies
Joshua A Wu, Katherine M Kutzer, Devika A Shenoy, Giussepe Yanez, Christian F Zirbes, Sharrieff Shah, Crystal Jing, Ankit Choudhury, Junho Song, Eric Mai, Suraj Dhanjani, Michael Shatkin, Grace Kim, Thorsten M Seyler, Kevin A Wu
Joshua A Wu, Department of Biology, University of Massachusetts Amherst, Amherst, MA 01003, United States
Katherine M Kutzer, Devika A Shenoy, Giussepe Yanez, Christian F Zirbes, Sharrieff Shah, Crystal Jing, Thorsten M Seyler, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States
Ankit Choudhury, Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, United States
Junho Song, Eric Mai, Suraj Dhanjani, Michael Shatkin, Kevin A Wu, Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
Grace Kim, Department of Internal Medicine, New York Presbyterian Hospital, New York, NY 10065, United States
Author contributions: Seyler TM and Wu KA designed the research study; Wu JA, Wu JA, Kutzer KM, Shenoy DA, Yanez G, Zirbes CF, Shah S, Jing C, and Choudhury A performed the literature review and data extraction; Wu JA, Song J, Mai E, Dhanjani S, Shatkin M, Kim G, Seyler TM, and Wu KA contributed to data interpretation and figure/table preparation; Song J, Mai E, Dhanjani S, Shatkin M, Kim G, and Seyler TM provided critical revisions and expert input on orthopedic applications; Wu KA supervised the project, reviewed all drafts, and approved the final version of the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: Seyler TM has done consulting work for Peptilogics and Restor3d; received royalties or IP-related income from Lippincott Williams & Wilkins, Pattern Health, Restor3d, and Smith & Nephew; held stock or stock options in MiCare Path and Restor3d; served as a board or committee member for American Association of Hip and Knee Surgeons and Musculoskeletal Infection Society; received research support from Zimmer.
Corresponding author: Kevin A Wu, MD, Researcher, Department of Orthopedics, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, New York, NY 10029, United States.
kevin.wu2@mountsinai.org
Received: September 26, 2025
Revised: October 16, 2025
Accepted: January 4, 2026
Published online: March 18, 2026
Processing time: 171 Days and 21.8 Hours
Functional outcome assessment in orthopedic surgery has long relied on patient-reported measures and intermittent clinical evaluations. While these tools provide valuable insight, they are often limited by subjectivity and may not accurately reflect real-world functional performance. Wearable technologies (“wearables”) have emerged as a promising means to capture objective, continuous, and ecologically valid data on mobility, activity levels, and joint mechanics. These devices, which range from consumer-grade fitness trackers to specialized medical-grade sensors, can enable detailed monitoring of recovery across various orthopedic contexts, including joint arthroplasty, fracture care, spine surgery, and sports injuries. By quantifying parameters such as gait patterns, step count, range of motion, and activity intensity, wearables offer a more nuanced understanding of functional recovery over time. Early evidence supports their ability to complement traditional assessments and enhance postoperative monitoring. However, challenges remain, including variability in device accuracy, patient adherence, data interpretation, and integration into clinical practice. As these technologies continue to evolve, they hold significant potential to personalize rehabilitation, support remote care models, and improve outcome measurement in orthopedic surgery. Ongoing research and standardization efforts will be critical to unlocking their full clinical utility.
Core Tip: Traditional outcome measures in orthopedic surgery rely heavily on patient-reported scores and periodic clinical evaluations, which may not fully capture real-world function. Wearable technologies provide continuous, objective, and ecologically valid data on mobility, activity, and joint mechanics. From fitness trackers to medical-grade sensors, these devices enable detailed monitoring of recovery after arthroplasty, fracture care, spine surgery, and sports injuries. By quantifying gait, step count, range of motion, and activity intensity, wearables complement traditional assessments and support personalized rehabilitation. Despite challenges with accuracy, adherence, and integration, ongoing research suggests they may transform postoperative monitoring and functional outcome evaluation.
