Study overview
Recovery after total knee replacement continues well beyond the active rehabilitation period. For patients, clinicians, and organizations evaluating care models, the question is not only whether a program improves outcomes at discharge, but whether those improvements last.
This follow-up study evaluated medium-term outcomes from Sword’s earlier total knee replacement rehabilitation study. The original study compared an 8-week home-based digital rehabilitation program with conventional in-person home rehabilitation. This analysis looked at whether outcomes were maintained at 3 and 6 months after surgery.
The study included 59 patients who completed follow-up assessments: 30 in the digital rehabilitation group and 29 in the conventional rehabilitation group. Researchers evaluated functional mobility, patient-reported knee outcomes, and range of motion using measures including Timed Up and Go, Knee Osteoarthritis Outcome Score, and knee range-of-motion assessments.
Key findings
Digital rehabilitation maintained stronger mobility outcomes
Patients in the digital rehabilitation group maintained stronger functional mobility outcomes at both 3 and 6 months after surgery.
At the 6-month assessment, the median between-group difference for Timed Up and Go change was 4.87 seconds, favoring the digital rehabilitation group.
Improvements exceeded clinically meaningful thresholds
The difference between groups was not only statistically significant. It was also clinically meaningful.
At both 3 and 6 months, the between-group difference in Timed Up and Go change was more than double the minimal clinically important difference, favoring patients who completed the digital rehabilitation program.
Patient-reported knee outcomes remained higher
Patients in the digital rehabilitation group reported stronger knee outcomes across Knee Osteoarthritis Outcome Score subscales at both 3 and 6 months.
At 6 months, the digital group maintained higher scores for symptoms, pain, activities of daily living, sports, and quality of life.
Range-of-motion outcomes became more similar over time
Knee range-of-motion outcomes began to converge between groups by 6 months, suggesting that both groups continued to recover over time.
However, standing knee flexion remained significantly higher in the digital rehabilitation group at the 6-month assessment.
No adverse events were reported during follow-up
No adverse events were reported in either group between the end of the active treatment period and the 6-month assessment. The study also reported no falls in either group during that period.
Why this study matters
This study looks beyond the active rehabilitation period.
Sword’s earlier total knee replacement study showed that home-based digital rehabilitation could support stronger outcomes at the end of an 8-week program. This follow-up analysis asked a different question: did those gains hold over time?
The findings suggest that patients in the digital rehabilitation group maintained stronger functional mobility and patient-reported knee outcomes at 3 and 6 months after surgery. That matters because recovery after total knee replacement is not only about short-term progress. It is about whether patients continue to regain function, confidence, and mobility in the months after surgery.
The study also reinforces an important part of Sword’s clinical model: home-based rehabilitation can be digitally guided, remotely monitored, and adapted over time while still supporting meaningful recovery.
This study should be understood as a medium-term follow-up to a feasibility study, not a large randomized trial. Still, it adds important evidence that digitally guided rehabilitation can support recovery beyond the active treatment window.
About the author
Fabiola Costa
Senior Director of Clinical Research, Sword Health
