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Effectiveness of Telerehabilitation After Total Knee Arthroplasty: An Umbrella Review
Huiping Xu1, Vivian W Q Lou2, Zixin Guo3
1The Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zheng zhou, China.
Background:
The use of telerehabilitation is increasing worldwide among patients who have undergone total knee arthroplasty (TKA). However, its efficacy and credibility in clinical settings remain unclear. An umbrella review (CRD420251070340) of the available scientific evidence was performed to determine whether telerehabilitation is an effective alternative to conventional rehabilitation among patients after TKA.
Methods:
We searched multiple databases through July 30, 2025, for relevant systematic reviews or meta-analyses. Effect sizes were recalculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs). The initial search retrieved 1,192 articles.
Results:
The trials showed a significant effect of telerehabilitation interventions on patients undergoing TKA (SMD = -0.06, 95% CI [-0.16 to 0.03], P < 0.001, I2 = 69.9%). The bias estimate was -0.423 (standard error (SE) = 0.809, P = 0.604). In subgroup analyses, telerehabilitation interventions all had a significant effect on patients who underwent TKA (SMD = -0.14, 95% CI [-0.28 to 0.01], P < 0.001, I2 = 73.9%; SMD = 0.02, 95% CI [-0.09 to 0.14], P = 0.005, I2 = 47.7%; SMD = -0.15, 95% CI [-8.53 to 8.23], P < 0.001, I2 = 95.9%, respectively). Range of motion (passive flexion) (SMD = 0.26, 95% CI [-0.06 to 0.58], P = 0.041, I2 = 59.8%), Western Ontario and McMaster Universities Osteoarthritis Index (SMD = -0.40, 95% CI [-0.75 to -0.05], P = 0.003, I2 = 69.9%), and Knee Injury and Osteoarthritis Outcome Score (SMD = -0.57, 95% CI [-3.52 to 2.39], P < 0.001, I2 = 85%) all showed improvement over traditional face-to-face rehabilitation among patients who underwent TKA.
Conclusions:
This body of evidence tends to support telerehabilitation compared with traditional face-to-face rehabilitation, as indicated by better range of motion (passive flexion), the Western Ontario and McMaster Universities Osteoarthritis Index, and the Knee injury and Osteoarthritis Outcome Score among patients who underwent TKA.
