Digital health-enabled home rehabilitation after total knee arthroplasty in older adults: A narrative review of technologies, evidence maturity and implementation considerations for person-centred care

Digital health may extend rehabilitation support after total knee arthroplasty (TKA), yet the evidence for older adults varies considerably across technologies. This narrative review examined the technologies, clinical functions, evidence maturity and implementation considerations of home-based digital rehabilitation after TKA. Eight English- and Chinese-language databases were searched from inception to May 2026. Eligible intervention and technical-validation studies were distinguished from contextual literature, and methodological quality was appraised using Joanna Briggs Institute tools. The review included 32 publications representing 31 underlying study samples. Telerehabilitation and remote therapy formed the largest and most mature evidence base, with short-term functional outcomes generally comparable to conventional rehabilitation. Evidence for mobile, cloud, wearable and virtual-reality approaches was more heterogeneous, while artificial-intelligence-assisted assessment was supported mainly by technical-validation rather than clinical-effectiveness studies. Across modalities, common limitations included small samples, single-centre designs, short follow-up, variable outcome reporting and limited economic evaluation. Digital rehabilitation may complement professional care when tailored to functional capacity, recovery goals, digital literacy and caregiver support. However, evidence on long-term effectiveness, cost-effectiveness and patients’ experiences remains insufficient. The proposed framework should therefore be interpreted as a hypothesis-generating synthesis rather than a validated implementation pathway.