Telerehabilitation Is a Valid Option for Total Knee Arthroplasty Patients: A Retrospective Pilot Study Based on Our Experience during the COVID-19 Pandemic

Michele Venosa; Emilio Romanini; Enrico Ciminello; Simone Cerciello; Massimo Angelozzi; Vittorio Calvisi

doi:10.3390/healthcare11182489

Telerehabilitation Is a Valid Option for Total Knee Arthroplasty Patients: A Retrospective Pilot Study Based on Our Experience during the COVID-19 Pandemic

Healthcare (Basel). 2023 Sep 7;11(18):2489. doi: 10.3390/healthcare11182489.

Authors

Michele Venosa^{1

2}, Emilio Romanini^{2

3}, Enrico Ciminello⁴, Simone Cerciello^{5

6}, Massimo Angelozzi¹, Vittorio Calvisi^{1

7}

Affiliations

¹ Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, Coppito 2, 67100 L'Aquila, Italy.
² RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini 44, 00167 Rome, Italy.
³ GLOBE, Italian Working Group on Evidence-Based Orthopaedics, Via Nicola Martelli 3, 00197 Rome, Italy.
⁴ Italian Implantable Prostheses Registry (RIPI), Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy.
⁵ Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy.
⁶ Orthopaedic Department, Casa di Cura Villa Betania, Via Pio IV 42, 00165 Rome, Italy.
⁷ UOSD, Department of Mini-Invasive and Computer-Assisting Orthopedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 L'Aquila, Italy.

Abstract

Introduction: Total knee arthroplasty is an effective operation. Post-surgery rehabilitation, based on early and intensive progressive exercise programs, plays a substantial role and telerehabilitation can be an effective safe option. This retrospective study aimed to compare traditional in-presence rehabilitation and telerehabilitation for total knee arthroplasty, based on our experience during the Italian COVID-19 lockdown.

Materials and methods: We retrospectively analyzed 164 patients (94 females and 70 males) enrolled in 2020 within 2 weeks after total knee replacement to perform post-operative outpatient rehabilitation. The clinical results of 82 patients (mean age 66.8 ± 10.2 years) performing telerehabilitation with those obtained from a similar cohort of 82 patients (mean age 65.4 ± 11.8 years) performing traditional in-presence outpatient rehabilitation were compared. Clinical outcomes were examined by comparing the gait speed (Time Up and Go-TUG test), the range of motion, the pain intensity (VAS), the functional status (Oxford Knee Score-OKS and Knee injury and Osteoarthritis Outcome Score-KOOS) and the overall satisfaction (Self-administered patient satisfaction scale) 12 weeks after the beginning of the physiotherapeutic protocol.

Results: Telerehabilitation was non-inferior to traditional in-presence rehabilitation in all of the investigated areas and no statistical difference in terms of effectiveness was detected at 12 weeks, as confirmed by the respective patient-reported outcome scores such as TUG test (reduced from 20 ± 2 s to 12 ± 1.5 s for the telerehab cohort and from 18 ± 1.5 s to 13.1 ± 2 s for the in-presence rehabilitation one), pain VAS, OKS (improved from 22 ± 1.3 to 36 ± 2.7 for the telerehab cohort and from 23 ± 2.1 to 35.1 ± 4.2 for the in-presence group), KOOS (improved from 46.2 ± 10.2 to 67.4 ± 3.8 for the telerehabilitation cohort and from 48.4 ± 8.4 to 68.3 ± 6.6 for the other group), and the Self-administered patient satisfaction scale (more than two-thirds of patients globally satisfied with the results of their surgery in both groups).

Conclusion: The telerehabilitation program was effective after total knee replacement and yielded clinical outcomes that were not inferior to conventional outpatient protocols.

Keywords: in-presence rehabilitation; outpatient rehabilitation; telerehabilitation; total knee arthroplasty.

Grants and funding

No funding was provided specifically for this project.