{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T11:44:32Z","timestamp":1788608672680,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":57,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The global increase in total knee arthroplasty has led to greater examination of postoperative recovery, particularly the effectiveness and purpose of rehabilitation. Although surgery reliably reduces pain and improves patient\u2010reported assessments of function, objectively measured physical activity commonly declines after surgery and often remains below preoperative levels for prolonged periods. This mismatch exposes shortcomings in traditional outcome measures and challenges longstanding assumptions about predictable, linear recovery. Emerging evidence from recent trials questions the clinical impact of conventional preoperative and postoperative rehabilitation programmes. At the same time, national registry data show that inadequate restoration of daily activity carries significant long\u2010term socioeconomic consequences. These findings collectively indicate a need to move beyond protocol\u2010driven models of rehabilitation towards a deeper understanding of the biological, behavioural and contextual factors that shape recovery. It proposes a conceptual shift towards personalised, dynamically reassessed recovery pathways informed by objective activity measurement, patient\u2010centred outcomes and mechanistic understandings of postoperative physiology. The central question is not whether rehabilitation is required, but how to identify which individuals need targeted therapy, at what point in their recovery, and through which interventions. Reframing rehabilitation in this way is essential to closing the gap between symptomatic improvement and meaningful functional recovery after knee replacement surgery.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Level of Evidence<\/jats:bold>\n                    N\/A, narrative commentary.\n                  <\/jats:p>","DOI":"10.1002\/jeo2.70673","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T09:19:18Z","timestamp":1772961558000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Do we need rehabilitation after total knee arthroplasty? Evidence, uncertainty and the need for focus"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7860-2990","authenticated-orcid":false,"given":"Thomas","family":"Wainwright","sequence":"first","affiliation":[{"name":"Orthopaedic Research Institute Bournemouth University  Poole UK"},{"name":"Physiotherapy Department University Hospitals Dorset NHS Foundation Trust Bournemouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2209-1711","authenticated-orcid":false,"given":"Henrik","family":"Kehlet","sequence":"additional","affiliation":[{"name":"Section of Surgical Pathophysiology, Rigshospitalet Copenhagen University Copenhagen Denmark"},{"name":"The Centre for Fast\u2010Track Hip and Knee Replacement Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocarto.2025.100601"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S341953"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2025-107087"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.21653\/tjpr.1374031"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15682"},{"key":"e_1_2_7_7_1","unstructured":"ISRCTN. Tracking physical activity after total knee replacement. 2024 [cited 2025 Dec 1]. Available from:https:\/\/www.isrctn.com\/ISRCTN18394084"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znae232"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000005542"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102510"},{"key":"e_1_2_7_11_1","first-page":"8","article-title":"A nationwide analysis of socioeconomic outcomes after hip and knee replacement","volume":"63","author":"Kjellberg J","year":"2016","journal-title":"Dan Med J"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-018-0185-5"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocarto.2024.100530"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.17.00015"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13010125"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43019-021-00118-y"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2017.10.007"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.2340\/17453674.2022.4567"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70673","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jeo2.70673","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T14:30:27Z","timestamp":1775917827000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/jeo2.70673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/jeo2.70673"],"URL":"https:\/\/doi.org\/10.1002\/jeo2.70673","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70673"}}