BackgroundTotal knee replacement is a commonly adopted surgical intervention to reduce physical limitations and pain in advanced-stage knee osteoarthritis. However, these patients may experience physical dysfunction to limit their access during conventional rehabilitation after total knee replacement. The use of telemedicine may be the promising solution. This study aims to compare the effectiveness of telerehabilitation with conventional in-person rehabilitation in patients who underwent a total knee replacement.MethodsFor this systematic review on randomized controlled trials, PubMed, Medline, EMBASE, Cochrane Library, ScienceDirect and CINAHL databases were searched for eligible articles published between 1 January 2003 and 28 February 2022. The eligibility criteria were patients who underwent total knee replacement, randomized controlled trials and publications in English. The main outcome measures were focused on pain and physical function. Reference lists of relevant studies were also manually checked to find additional studies. Two independent reviewers conducted study selection separately. PEDro scale was used to assess the methodological quality of the included randomized controlled trials. A meta-analysis was performed on the collected data. Review Manager (RevMan, version 5.3) was used for all analyses.ResultsA total of 11 studies met the eligibility criteria and included 1825 participants in the systematic review. Overall, the results revealed that the effectiveness of telerehabilitation is comparable to conventional in-person rehabilitation in improving various pain and functional outcomes in patients who underwent a total knee replacement. In the meta-analysis with the fixed-effects model, no significant difference was found in the improvement of pain and physical function in patients with knee osteoarthritis compared with conventional rehabilitation (Standardized Mean Difference (SMD) –0.15, 95% CI −0.47 to 0.16, P = 0.34 and SMD –0.04, 95% CI −0.19 to 0.12, P = 0.62, respectively). In addition, the utilization of hospital resources and costs were significantly lower in telerehabilitation when compared with in-person rehabilitation.ConclusionTelerehabilitation was comparable to conventional in-person rehabilitation in improving clinical outcomes following total knee replacement. However, it might be a more preferable alternative rehabilitation intervention for patients following total knee replacement given the significantly lower cost of telerehabilitation.

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全膝关节置换术后患者远程康复的有效性：随机对照试验的系统评价和荟萃分析

背景全膝关节置换术是一种普遍采用的外科手术干预措施，以减少晚期膝关节骨性关节炎的身体限制和疼痛。然而，这些患者可能会出现身体功能障碍，从而限制他们在全膝关节置换术后常规康复过程中的进入。远程医疗的使用可能是有希望的解决方案。本研究旨在比较远程康复与常规现场康复对接受全膝关节置换术的患者的有效性。发表于 2003 年 1 月 1 日至 2022 年 2 月 28 日之间的文章。入选标准是接受全膝关节置换术的患者，随机对照试验和英文出版物。主要结果测量集中在疼痛和身体功能上。还手动检查了相关研究的参考列表以找到其他研究。两名独立评审员分别进行研究选择。PEDro量表用于评估纳入随机对照试验的方法学质量。对收集的数据进行了荟萃分析。所有分析均使用 Review Manager（RevMan，版本 5.3）。结果共有 11 项研究符合资格标准，包括 1825 名参与者参加系统评价。总体而言，结果表明，远程康复在改善接受全膝关节置换术的患者的各种疼痛和功能结果方面的效果与传统的面对面康复相当。P  = 0.34 和 SMD –0.04, 95% CI -0.19 至 0.12, P  = 0.62，分别）。此外，与现场康复相比，远程康复对医院资源和成本的利用显着降低。结论远程康复在改善全膝关节置换术后临床结果方面与传统的现场康复相当。然而，鉴于远程康复的成本显着降低，对于全膝关节置换术后患者来说，这可能是一种更可取的替代康复干预措施。