Musculoskeletal Digital Therapeutics and Digital Health Rehabilitation: A Global Paradigm Shift in Orthopedic Care

Musculoskeletal disorders (MSDs) affect over 1.7 billion people globally and represent the leading cause of disability worldwide. Conventional rehabilitation strategies face challenges including limited accessibility, suboptimal adherence, and lack of personalization. Digital therapeutics (DTx)-evidence-based, software-driven interventions regulated as medical devices-have emerged as transformative solutions in chronic disease management. This review provides a narrative synthesis of representative studies in the field, drawing on a broad survey of literature from medical and engineering sources to capture current trends and clinically relevant developments. Seventy-five publications were examined, including clinical trials and validation studies, many of which reported outcomes comparable or superior to traditional rehabilitation approaches, with adherence gains of 15-40% and cost reductions of approximately 30-40%. We summarize the major technological foundations of musculoskeletal DTx and digital rehabilitation across orthopedic subspecialties, describing core-enabling technologies including artificial intelligence-driven motion analysis, wearable sensors, tele-rehabilitation platforms, and cloud-based ecosystems. Clinical applications spanning spine, upper and lower extremities, sports injuries, and trauma were analyzed alongside global regulatory frameworks, economic considerations, and implementation challenges. Early clinical evidence demonstrates improvements in functional outcomes, adherence, and cost-effectiveness. Future directions include digital twin-based precision rehabilitation, predictive analytics, and scalable integration into value-based orthopedic care. By establishing a comprehensive framework for musculoskeletal DTx implementation, this review highlights their potential to improve outcomes, reduce healthcare costs, and address global rehabilitation access gaps. However, evidence on long-term effectiveness, sustained cost benefits, and large-scale clinical integration remains limited and warrants further investigation.