Telerehabilitation Versus Clinic-Based Rehabilitation for Functional Recovery Following Primary Total Knee Arthroplasty

The goal of this clinical trial is to determine if rehabilitation delivered by telehealth works as well as rehabilitation delivered in person at a clinic, for people recovering from total knee replacement surgery. The main question it aims to answer is: • Does rehabilitation by video call lead to knee-related quality of life that is just as good as rehabilitation completed in person at a clinic? Researchers will compare a telehealth group to a clinic group to see if telehealth rehabilitation works as well as in-person rehabilitation. Participants will: * Take part in 9 rehabilitation sessions over 6 weeks, either by video call from home or in person at a clinic * Follow a home exercise program using an online app * Answer questions about their knee and daily activities before surgery, and again at 7 weeks, 6 months, and 12 months after surgery * Have their knee movement and physical abilities, such as walking speed and climbing stairs, measured by a therapist before surgery, and again at 7 weeks, and 12 months after surgery

Inclusion Criteria: * undergoing primary elective TKA for the treatment of end stage knee OA * ability to independently provide informed consent * a willingness to attend all rehabilitation sessions and assessment time points, irrespective of the delivery Exclusion Criteria: * comorbidities preventing participation in rehabilitation (e.g., severe obstructive pulmonary disease, hemiplegia) * revision TKA * intra-operative complications precluding rehabilitation * likely difficulties with follow-up * inability to read or speak English * unable to attend in person clinic visits due to travel distance * unwillingness to comply with the rehabilitation protocol