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Robotic-Assisted Early Rehabilitation Post Total Knee Arthroplasty: An Experimental Investigation

Authors :

Raed Abdulameer Mahmood Alalvani¹ Ali Selk Ghafari²

1- دانشگاه صنعتی فرات الاوسط 2- دانشگاه صنعتی شریف پردیس بین الملل کیش

Keywords :

Robotic_assisted،Rehabilitation،Total Knee Arthroplasty،Clinical Investigation،Experiment

Abstract :

Total Knee Arthroplasty (TKA) is an orthopedic surgery that requires immediate rehabilitation as a standard practice. Stiffness reduction, Range of Motion (ROM), and functionality restoration can be achieved by Continuous Passive Motion (CPM) devices. Their application in clinical settings is a subject of ongoing debate. In this research, a lightweight one-degree-of-freedom (DOF) knee robotic exoskeleton is proposed to replace CPM devices. The proposed system provides continuous torque delivery of 15 Nm from 0° to 110°, with features such as emergency stop capabilities and multimodal control (position, impedance, torque). Clinical trials were conducted at Al-Zahra Clinic, Marjan Medical Hospital, and Babylon Rehabilitation Center in Iraq. Twenty patients (60% female, 40% male) who had undergone TKA participated in four weekly sessions receiving rehabilitation using the prototype. Clinical outcomes were measured using pain levels (VAS), knee ROM, functional mobility (6MWT), quadriceps strength, and patient-reported outcomes (WOMAC). The findings showed that the robotic exoskeleton was an effective replacement for CPM, allowing for early mobilization in upright, sitting, and partially standing positions. Patients experienced increase in passive ROM, reduced VAS pain scores at rest and during activity, and clinically significant improvements in functional mobility, 6MWT. Low stiffness scores on the WOMAC subscale indicated improved performance in daily activities, high patient compliance, and tolerance. No significant adverse effects were reported. The proposed robotic exoskeleton demonstrated safety, feasibility, clinical benefit for early TKA rehabilitation and scalable alternative to conventional CPM systems.