Dr. MacNeille Hip and Knee logo Rhett MacNeille, MD Hip & Knee Replacement Request an Appointment

Physical Therapy After Joint Replacement — Including Video and Remote Options

Recovery

A new hip or knee is only half the story. The other half is what you do with it. Structured physical therapy (PT) after joint replacement helps you regain motion, rebuild strength, and return to the activities you love. Today, that therapy does not always require driving to a clinic — and the research backs this up.

Why Physical Therapy Matters

After surgery, your joint needs guided movement to heal well. PT helps you:

  • Restore bending and straightening (especially important after knee replacement)
  • Rebuild the thigh and hip muscles that support your new joint
  • Walk with a normal pattern instead of a limp
  • Reduce swelling and stiffness through proven exercises

Modern recovery programs, including the Enhanced Recovery After Surgery guidelines published in Acta Orthopaedica (2020), emphasize getting patients up and moving early — often the same day as surgery.

Does Remote PT Really Work?

Many patients assume in-person therapy must be better. The evidence says otherwise. In a landmark randomized trial of 205 knee replacement patients, Moffet and colleagues (Journal of Bone and Joint Surgery, 2015) compared in-home video telerehabilitation with traditional face-to-face therapy. The results were clinically equivalent: patients in both groups had similar improvements in pain, stiffness, and function two months after surgery.

Larger reviews agree. A systematic review and meta-analysis by Tsang and colleagues (Journal of Telemedicine and Telecare, 2024) pooled randomized trials of telerehabilitation after knee replacement and found outcomes comparable to conventional therapy. And a 2024 meta-analysis of 25 randomized trials covering more than 4,400 patients, published by Liu and colleagues in the Journal of Orthopaedic Surgery and Research, found telerehabilitation matched or even exceeded in-person therapy for pain relief, knee motion, and quadriceps strength — at lower cost to patients.

Who Benefits Most from Video PT?

Remote therapy can be a great fit if you:

  • Live in a rural area or far from an outpatient clinic
  • Have limited transportation, especially in the early weeks when you cannot drive
  • Prefer to recover in the comfort of home
  • Want flexible scheduling around work or caregiving

Your therapist guides you through exercises by video, watches your form, and adjusts your program — much like an in-person visit.

Your Options in Our Practice

Dr. MacNeille's practice offers both paths. We can refer you to a traditional outpatient physical therapy clinic near your home, or set you up with video-based remote PT if that fits your life better. Some patients even combine the two. What matters most is not where you do therapy — it is that you do it consistently.

Before surgery, we will talk through your home setup, distance from a clinic, and personal preferences to choose the option that gives you the best recovery.

References

  • Moffet H, Tousignant M, Nadeau S, et al. In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty: a noninferiority randomized controlled trial. Journal of Bone and Joint Surgery (Am). 2015.
  • Tsang MP, Man GCW, et al. The effectiveness of telerehabilitation in patients after total knee replacement: a systematic review and meta-analysis of randomized controlled trials. Journal of Telemedicine and Telecare. 2024.
  • Liu X, et al. Efficacy of telerehabilitation for total knee arthroplasty: a meta-analysis based on randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2024.
  • Wainwright TW, et al. Consensus statement for perioperative care in total hip and knee replacement: ERAS Society recommendations. Acta Orthopaedica. 2020.

This article is for general education and is not a substitute for medical advice.


Watch: see it for yourself

Walking demo at three weeksA walking demonstration at the three-week follow-up after knee replacement.

Recovery videos courtesy of Dr. Lige Kaplan, whose patients underwent the same minimally invasive techniques Dr. MacNeille uses. Robotics videos from Stryker and partner hospitals. We will be adding videos of our own patients over time. Browse the full video library →


Ready to talk about your hip or knee? Request an appointment and our team will contact you within 1–2 business days.