Effects of a Home-Based Prehabilitation Program on Biomarkers and Hospital Outcomes in Total Knee Arthroplasty: A Protocol for a Randomized Controlled Trial

Background Prehabilitation programs have gained attention for their potential to improve surgical outcomes in patients undergoing total knee arthroplasty (TKA). Exercise may modulate inflammatory markers (e.g., CRP and IL-6), nutritional and coagulation profiles, and joint-specific biomarkers, factors that influence postoperative recovery. However, the effects of preoperative exercise on these biological mechanisms in TKA patients remain insufficiently investigated. Methods This trial presents the protocol for an eight-week, semi-supervised, home-based prehabilitation program designed for patients scheduled for TKA. Participants will be randomized into an intervention group, which will perform exercises with remote supervision, or a control group, which will receive usual care. The primary outcomes included changes in inflammatory, nutritional, and coagulation biomarkers pre- and post-TKA. The secondary outcomes included hospital length of stay, postoperative complications, self-reported pain, stiffness, function, and satisfaction. Data will be collected at baseline, before surgery, and during postoperative follow-up. Discussion Home-based interventions may offer a scalable alternative to traditional prehabilitation, improving accessibility in large healthcare systems. By integrating structured preoperative exercise with remote supervision, this study sought to determine whether prehabilitation can modulate key biomarkers, enhance functional recovery, and reduce surgical risk. The results will contribute to the growing body of evidence supporting home-based prehabilitation strategies, providing insights into their potential role in optimizing TKA recovery. These findings may inform future rehabilitation protocols and healthcare policies, particularly in resource-limited public health systems. The trial was registered with ClinicalTrials.gov under the identifier RBR-4HSKT2D on March 18, 2025.