{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:24:25Z","timestamp":1792563865564,"version":"4.5.0"},"reference-count":58,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JFMK"],"abstract":"<jats:p>Background: Total hip and knee arthroplasty are common procedures for end-stage osteoarthritis, with rehabilitation playing a central role in functional recovery. Conventional face-to-face programs are often limited by accessibility, costs, and logistical barriers. Digital telerehabilitation has been increasingly investigated as an alternative. This review aims to summarize current evidence on its effectiveness, patient-reported outcomes, satisfaction, and economic impact. Materials and Methods: A narrative review was conducted using Medline, Web of Science, and Scopus up to April 2025. Randomized controlled trials and longitudinal studies evaluating telerehabilitation after total hip or knee arthroplasty were included. Data were extracted on functional performance, pain, autonomy, quality of life, patient satisfaction, and cost-effectiveness. Results: Across multiple RCTs, telerehabilitation produced functional outcomes generally comparable to conventional rehabilitation, with some studies reporting superior short-term improvements. For example, in a retrospective trial, Timed Up and Go improved by \u22128.0 \u00b1 2.6 s in the digital group versus \u22124.9 \u00b1 2.5 s with standard care (p &lt; 0.01). Tablet-assisted programs reduced Five Times Sit-to-Stand times to 11.7 s at 6 months compared with 14.7 s in controls (p = 0.05). In hip arthroplasty, digital rehabilitation resulted in higher active flexion (97.4\u00b0 vs. 89.9\u00b0, p = 0.018) and abduction (51.7\u00b0 vs. 43.8\u00b0, p = 0.024). Quality-of-life measures, such as EQ-5D VAS, also showed improvements (82.9 \u00b1 4.3 vs. 68.7 \u00b1 4.6 at 6 months). Some studies reported higher patient satisfaction, for instance, a VR-based RCT found GPE at day 15 of 4.76 \u00b1 0.43 in the intervention group versus 3.96 \u00b1 0.65 in controls (p &lt; 0.001). Conclusions: Telerehabilitation after hip and knee arthroplasty appears to produce short-term functional and patient-reported outcomes comparable to conventional rehabilitation in selected populations. Evidence of superiority is limited and heterogeneous, and long-term effectiveness, equity, and cost-effectiveness remain uncertain. Heterogeneity in protocols and digital literacy barriers highlight the need for standardized guidelines and further independent validation.<\/jats:p>","DOI":"10.3390\/jfmk10040370","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T12:33:03Z","timestamp":1758889983000},"page":"370","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Telerehabilitation in Hip and Knee Arthroplasty: A Narrative Review of Clinical Outcomes, Patient-Reported Measures, and Implementation Challenges"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7059-935X","authenticated-orcid":false,"given":"Rocco Maria","family":"Comodo","sequence":"first","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"},{"name":"Orthopedics and Trauma Surgery, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Grassa","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8331-0826","authenticated-orcid":false,"given":"Alessandro El","family":"Motassime","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4591-4015","authenticated-orcid":false,"given":"Guido","family":"Bocchino","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Totti","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8321-532X","authenticated-orcid":false,"given":"Andrea","family":"De Fazio","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Meschini","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9565-6691","authenticated-orcid":false,"given":"Giacomo","family":"Capece","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"},{"name":"U.O.C. Orthopaedics and Traumatology, Pellegrini Hospital, 80134 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Maccauro","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2321-9665","authenticated-orcid":false,"given":"Raffaele","family":"Vitiello","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart Rome, 20123 Milan, Italy"},{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Orthopaedics and 3 Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1016\/S0140-6736(19)30417-9","article-title":"Osteoarthr","volume":"393","author":"Hunter","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1002\/art.34453","article-title":"Osteoarthritis: A disease of the joint as an organ","volume":"64","author":"Loeser","year":"2012","journal-title":"Arthritis Rheum."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1002\/acr.24131","article-title":"2020 American College of Rheumatology guideline for the management of osteoarthritis","volume":"72","author":"Kolasinski","year":"2020","journal-title":"Arthritis Care Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/S0140-6736(18)32531-5","article-title":"How long does a knee replacement last? 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