The added value of multimodal biopsychosocial teleprehabilitation in people undergoing total knee arthroplasty

Total knee arthroplasty (TKA) is one of the most performed elective surgeries (>25k/year in Belgium). Unfortunately, up to 34% of patients experience moderate to severe persistent postoperative pain and approximately 20% are dissatisfied with the outcome. Moreover, in those patients that experience favorable outcomes, the expected (re)uptake of physical activity often fails to materialize. This illustrates that current (p)rehabilitation strategies are not effectively targeting physical activity. Nevertheless, regular physical activity is desirable both to enhance postoperative recovery and to obtain major general health benefits. Therefore, a shift in TKA care is warranted with a specific focus on modifying known risk factors for unfavorable outcome and the promotion of regular physical activity. A window-of-opportunity lays in the preoperative waiting phase. With this project I aim to investigate the long-term (cost-)effectiveness and (part of) the underlying mechanism of multimodal biopsychosocial teleprehabilitation combining (pain neuroscience) education, stress management and promotion of physical activity guided by motivational interviewing. This intervention is specifically designed to address risk factors for unfavorable recovery and facilitate a long-term behavioral change towards an active lifestyle, with strong potential for a socio-economic benefit. This will lead to an important optimization of the TKA care trajectory with an expected high impact on the field.