Effectiveness of Telerehabilitation After Total Knee Arthroplasty: An Umbrella Review.
Huiping Xu, Vivian W Q Lou, Zixin Guo et al.
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In 30 seconds
This umbrella review assessed whether telerehabilitation is an effective alternative to conventional face-to-face rehabilitation after total knee arthroplasty (TKA). The authors searched for systematic reviews and meta-analyses published through July 30, 2025, and recalculated effect sizes. Across the included evidence, the overall estimate was small and its 95% confidence interval included no effect (SMD = -0.06, 95% CI [-0.16 to 0.03]), despite the abstract reporting P < 0.001. The authors concluded that evidence tends to support telerehabilitation, citing improvements in passive flexion and patient-reported outcome measures.
Key findings
- The overall effect estimate was SMD = -0.06, 95% CI [-0.16 to 0.03], with substantial heterogeneity (I 2 = 69.9%).
- Passive flexion showed an estimated improvement of SMD = 0.26, 95% CI [-0.06 to 0.58].
- The Western Ontario and McMaster Universities Osteoarthritis Index showed SMD = -0.40, 95% CI [-0.75 to -0.05].
- The Knee Injury and Osteoarthritis Outcome Score estimate was SMD = -0.57, 95% CI [-3.52 to 2.39], with high heterogeneity (I 2 = 85%).
Why it matters
Rehabilitation is an important part of recovery after TKA, and this review evaluates remote delivery against conventional face-to-face care. Its findings suggest possible benefits in mobility and patient-reported outcomes, but the overall estimate is close to no effect and several outcome estimates are imprecise. These results help frame telerehabilitation as a potential option while underscoring uncertainty in the evidence.
What to keep in mind
The review synthesised existing systematic reviews and meta-analyses, and reported substantial heterogeneity. Several outcome confidence intervals included no effect, limiting certainty about comparative benefit.