Abstract
Total hip arthroplasty (THA) is among the most effective orthopedic interventions for osteoarthritis, yet post-operative rehabilitation is frequently delayed due to informational and organizational barriers. Geographic information system (GIS) technology offers a promising approach to improving rehabilitation access coordination, though its integration into patient-facing mobile platforms remains insufficiently studied. This two-arm, parallel-group, superiority randomized controlled trial enrolled 142 adult patients (≥18 years) within seven days of primary THA at the National Research Oncology Center LLC, Astana, Kazakhstan. Participants were randomized 1:1 to the GIS-integrated Health-GIS mobile coordination platform (experimental group) or standard general practitioner (GP)-mediated referral (control group). Key exclusion criteria included severe cognitive or visual impairment, absence of smartphone access or digital literacy, and medical contraindications to rehabilitation. The primary outcomes were time to second-stage rehabilitation initiation and health-related quality of life assessed by the SF-12 (Physical and Mental Component Summaries). Secondary outcomes included the Harris Hip Score (HHS), Visual Analogue Scale (VAS) for pain, System Usability Scale (SUS), and quality-adjusted life years (QALYs) over a 12-month follow-up. Of 142 randomized participants (61% male, 39% female), 131 completed follow-up and were included in the modified intention-to-treat analysis (experimental: n = 66; control: n = 65). The experimental group initiated second-stage rehabilitation significantly earlier (median 43 vs. 59 days; p = 0.021). At 12 months, the experimental group demonstrated superior SF-12 Physical Component Summary scores (48.21 vs. 42.84; p < 0.001), while Mental Component Summary scores did not differ significantly between groups (46.96 vs. 47.05; p = 0.669). Quality-adjusted life years were significantly higher in the experimental group (0.74 ± 0.04 vs. 0.72 ± 0.04; p = 0.008). Harris Hip Scores were significantly better in the experimental group at 6 weeks (p < 0.001) and 6 months (p = 0.009), converging by 12 months (p = 0.068). No statistically significant between-group differences in pain intensity (VAS) were observed at any time point (baseline: p = 0.814; 6 weeks: p = 0.336; 6 months: p = 0.066; 12 months: p = 0.105). Platform usability was rated as good-to-excellent by clinicians (SUS: 86.9 at 6 months) and acceptable by patients (mean SUS: 71.4). A GIS-integrated mobile coordination platform significantly reduced time to rehabilitation initiation and improved physical health-related quality of life and health utility following THA compared to standard referral practice. These findings support platform-based care coordination as an effective complement to surgical care, with important implications for rehabilitation access policy. Future multi-center studies and formal cost-effectiveness analyses are warranted to establish generalizability. Trial Registration: ClinicalTrials.gov, NCT07201116, registered 23 September 2025.