Virtual versus in-person physiotherapy following total knee arthroplasty: a comparative analysis

• Published in: International orthopaedics 2024-01, Vol.48 (1), p.65-70
• Main Authors: Charalambous, Alexander, Ekhtiari, Seper, Wainwright, Amy V., Najafi, Roxana, Chaudhry, Harman, Pincus, Daniel, Ravi, Bheeshma
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Paper; Orthopedics
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-023-06054-8

Purpose At our centre, we developed and implemented a video-based post-operative physiotherapy program for patients undergoing total knee arthroplasty (TKA). Our aims were to analyse and compare the outcomes of this program to in-person physiotherapy. Methods We reviewed the outcomes of 112 patients and captured range-of-motion (ROM) measurements and pain scores (P4 questionnaire). We compared the outcomes to a cohort of 175 patients undergoing in-person therapy. Comparative analysis was performed using a two-tailed Student’s t -test. Results There was no significant difference between the two groups in age, sex, or initial post-operative knee ROM. On discharge from virtual physiotherapy, mean flexion was 122.6° (SD 7.6). There was no significant difference in improvement in knee flexion between the virtual and in-person groups (mean 30.6° vs 34.0°, p  = 0.07). There was no significant difference in the proportion of patients achieving ≥ 120° of flexion (85.0% virtual vs 91.3% in-person, p  = 0.11) or those achieving an extension deficit of ≤ 5° (96.0% vs 98.3%, p  = 0.25). There was no difference in the number of PT visits to discharge (10.5 vs 11.1, p  = 0.14) or final pain scores (12.4 vs 11.9, p  = 0.61). Conclusion Improvements in knee ROM measures are comparable between virtual and in-person physiotherapy with both groups achieving a good functional range. These findings have implications for the virtual delivery of healthcare, especially among remote populations and patients with mobility limitations.