Efficacy of telerehabilitation for total knee arthroplasty: a meta-analysis based on randomized controlled trials combined with a bibliometric study.

BACKGROUND

Physical therapy (PT) is widely employed in osteoarthritis (OA). This study aimed to explore the research development of PT for OA and to identify the emerging treatment, and verify its efficacy.

MATERIALS AND METHODS

The Web of Science Core Collection was used to conduct the bibliometric analysis. Furthermore, a meta-analysis based on randomized controlled trials (RCTs) was performed to evaluate the identified treatment's efficacy.

RESULTS

A total of 3,142 articles were retrieved from the Web of Science Core Collection, and the annual publication volume shows an exponential growth trend (R = 0.9515). Keyword analysis demonstrated that telerehabilitation (TELE) in total knee arthroplasty (TKA) has become a hotspot since 2020. To assess the effectiveness of TELE, we conducted a meta-analysis of 25 RCTs including 4402 patients. In the total analysis, the TELE group exhibited superior outcomes compared to the traditional face-to-face (FTF) rehabilitation group in terms of pain (standardized mean differences [SMD]: - 0.15, 95% CI - 0.27 to - 0.04, P = 0.01), passive flexion (MD: 2.60, 95% CI 0.77 to 4.44, P = 0.005), quadriceps muscle strength (SMD: 0.32, 95% CI 0.04 to 0.61, P = 0.03), and cost (SMD: - 0.50, 95% CI - 0.88 to - 0.12, P = 0.009). The subgroup analysis also demonstrated that the fixed equipment-assisted telerehabilitation (FEAT) group and the mobile device-assisted telerehabilitation (MDAT) group were superior to the FTF group. Moreover, patients in the FEAT group exhibited better prognoses than those in the MDAT group. No significant differences in the other measured outcome were observed.

CONCLUSION

Telerehabilitation proved to be more effective than traditional FTF rehabilitation in patients who underwent TKA. Further research is warranted to compare the different TELE interventions to establish the best protocols and timing for interventions.