Development and Feasibility Evaluation of a Telerehabilitation Program After Total Knee Arthroplasty: A Cross-sectional Study of Surgeons and Patients

Background Total knee arthroplasty (TKA) is a common surgical procedure that requires structured postoperative rehabilitation to optimize functional recovery. Conventional supervised rehabilitation is associated with high costs, transportation barriers, and limited patient adherence. Telerehabilitation may provide a scalable alternative; however, the clinical reasonableness of structured programs and their feasibility and acceptability among both clinicians and patients remain unclear. This study aimed to evaluate a newly developed telerehabilitation program for patients undergoing TKA from both surgeon and patient perspectives. Methods A cross-sectional study was conducted. A nationwide questionnaire survey was distributed to orthopedic surgeons in China to evaluate the clinical reasonableness of a structured telerehabilitation program consisting of 30 exercises across four postoperative phases. In addition, patients scheduled for TKA between March and April 2023 were invited to complete practical assessments of five representative exercises after watching instructional videos. Patient understanding, ability to perform the exercises, acceptance of telerehabilitation, and factors influencing comprehension and acceptance were analyzed. Results A total of 148 orthopedic surgeons and 152 patients participated. Most surgeons considered postoperative rehabilitation essential and supported home-based rehabilitation after discharge. Over 80% of surgeons rated most exercises in the program as clinically reasonable, although approximately one quarter expressed concerns regarding wall squat exercises in later rehabilitation phases. Among patients, 84.21% reported understanding the exercise instructions and successfully performing the recommended movements, and 92.11% expressed willingness to participate in telerehabilitation. Lower education level and shorter daily smartphone use were associated with reduced understanding of the rehabilitation program, while limited smartphone use was the main factor associated with lower acceptance. Conclusions The proposed telerehabilitation program for patients undergoing TKA was considered clinically reasonable by surgeons and was feasible and acceptable to most patients. This program may provide a scalable and resource-efficient rehabilitation pathway and supports the integration of digital rehabilitation into routine orthopaedic care.