Robotergestützte Rehabilitation nach Knieendoprothese: Sinn oder Unsinn?

Innovative technologies for postoperative patient rehabilitation consist of eHealth, virtual reality, telemedicine and wearables. The latter can be combined with robotic support structure and form the basis of robot-assisted rehabilitation devices. Besides the potential side effects of cost reduction, the relief of human resources, particularly in structurally disadvantaged regions, shows a potential socioeconomic benefit of these machines. The potential cost-effectiveness and the evaluation of clinical benefits in terms of patient-oriented aftercare remains the subject of current research. Two systematic reviews have shown that the use of these innovative devices may be a useful add-on strategy as part of conventional rehabilitation. For the early and midterm postoperative period, partly significant improvements of walking ability, range of motion, pain level and muscle function were observed. However, due to the limited patient numbers, the heterogeneity of the available studies, the associated potential bias (selection bias, performance bias, attrition bias), an evidence-based assessment of robotic-assisted rehabilitation after total knee arthroplasty can currently not be undertaken. To date, these technologies seem to represent a useful add-on therapy within the postoperative rehabilitation process. Due to the upcoming structural and personal challenges in health systems, studies regarding robotic-assisted rehabilitation should continue to identify the best possible applications.