To explore the early rehabilitation effects of the health action process approach (HAPA)-based prehabilitation in robot-assisted total knee arthroplasty (rTKA).

A total of 74 patients undergoing revision total knee arthroplasty (rTKA) at the 920th Hospital of the Joint Logistics Support Force between August 2021 and March 2024 were enrolled. Inclusion criteria: meeting the diagnostic criteria for end-stage knee osteoarthritis and providing informed consent for rTKA; knee flexion contracture< 15°; absence of systemic or local infectious diseases; and the ability of the patient or accompanying family member to use WeChat on a mobile phone. Exclusion criteria: knee revision surgery; presence of neurological disorders affecting the knee joint; and severe chronic comorbidities. Patients were randomly assigned to either the control group or the intervention group (37 cases per group) by random number table. The control group received routine preoperative rehabilitation training, while the observation group received additional HAPA-based prehabilitation interventions alongside routine preoperative rehabilitation. Independent samples t tests and repeated-measures analysis of variance (ANOVA) were employed to compare knee range of motion (ROM), quadriceps muscle strength, and balance ability assessed before operation, one and three months after operation. Additionally, the Knee Society score (KSS) knee score, KSS function score, and hemoglobin decline were compared between the groups before operation and three months after operation.

Repeated measures ANOVA revealed significant between-group, time, and interaction effects for ROM, quadriceps strength, and balance ability (inter-group effect: F=9.045, 6.088, 4.255, time effect: F=319.597, 164.419, 114.488, interaction effect: F=4.712, 7.065, 4.434, all P<0.05). Simple effect analysis demonstrated superior ROM, quadriceps strength, and balance ability in the intervention group at one and three months postoperatively (P<0.05). No significant inter-group differences were observed in hemoglobin decline (t=0.538, P>0.05) or KSS knee and function scores at three months (t=0.320, 0.262, both P>0.05).

HAPA-based prehabilitation can effectively improve joint mobility, enhance core muscle strength around the knee, and promote balance recovery in rTKA patients, facilitating early postoperative rehabilitation.