Effectiveness of Preoperative Rehabilitation and Telerehabilitation in Total Knee Arthroplasty: A Meta-Analysis

Strategic Insights -

Research findings published in Archives of Physical Medicine and Rehabilitation have shed light on the effectiveness of preoperative rehabilitation and telerehabilitation in total knee arthroplasty (TKA). A meta-analysis of randomized controlled trials revealed that preoperative rehabilitation yielded significant improvements in functional recovery and pain relief after TKA, particularly during the mid-term phase. Notably, home-based telerehabilitation demonstrated superior efficacy compared to clinic-based approaches, suggesting a paradigm shift in perioperative TKA management.

Key Takeaways:

  • Preoperative rehabilitation resulted in significant improvements in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-function scores at mid-term (SMD, -1.21; 95% CI, -2.14 to -0.28; P=.011) and long-term follow-up (SMD, -0.47; 95% CI, -0.90 to -0.04; P=.033).
  • Home-based telerehabilitation consistently outperformed clinic-based approaches across most outcome measures, demonstrating superior overall effectiveness with more stable results.
  • Preoperative rehabilitation enhanced functional recovery and pain relief after TKA, with benefits primarily during the mid-term phase.
  • Twenty-nine trials encompassing 2157 participants fulfilled the inclusion criteria, with moderate evidence quality reaching levels of moderate quality.
  • Extensive sensitivity testing validated the robustness of treatment effects across all measured outcomes, despite considerable heterogeneity (I 75%).
  • The consistent benefits across diverse interventions support the general principle of preoperative conditioning despite methodological heterogeneity.
  • Researchers concluded that home-based telerehabilitation demonstrated superior efficacy compared with clinic-based approaches, suggesting a paradigm shift in perioperative TKA management.

Statistics:

  • 29 trials encompassing 2157 participants fulfilled the inclusion criteria.
  • Moderate evidence quality reached levels of moderate quality.
  • I 75% heterogeneity persisted throughout the analyses.
  • SMD (Standardized Mean Difference) -1.21 (95% CI, -2.14 to -0.28; P=.011) for WOMAC-function scores at mid-term.
  • SMD -0.47 (95% CI, -0.90 to -0.04; P=.033) for WOMAC-function scores at long-term follow-up.
  • 20% of participants in the control group received usual care, while 80% received preoperative rehabilitation.
  • No significant differences in WOMAC-pain scores at mid-term (SMD, -0.81; 95% CI, -1.35 to -0.27; P=.003) were observed between groups.

Sources:

  • Effectiveness of Preoperative Rehabilitation Compared With Usual Care in Total Knee Arthroplasty: A Meta-analysis of Randomized Controlled Trials. Archives of Physical Medicine and Rehabilitation, 2025.
  • First Hospital of China Medical University. [1]
  • PubMed, Embase, Web of Science, and Cochrane databases. [2]
  • PRISMA 2020 guidelines. [3]
  • Lin Peng, Dept. of Dermatology, First Hospital of China Medical University and Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, People's Republic of China. [1]
  • Zhengkun Wang, Xiaoyi Yang, Runshi Xu, Yujing Zhang, Xinyang Yu, Hang Li and Yijie Gao. [1]
  • Archives of Physical Medicine and Rehabilitation. W B Saunders Co-elsevier Inc, 1600 John F Kennedy Boulevard, Ste 1800, Philadelphia, PA 19103-2899, USA. [4]
  • NewsRx. Reports from First Hospital of China Medical University Add New Data to Findings in Telerehabilitation (Effectiveness of Preoperative Rehabilitation Compared With Usual Care in Total Knee Arthroplasty: A Meta-analysis of Randomized Controlled ...). Health & Medicine Week. October 24, 2025; p 1461. [5]