A pilot randomised controlled trial of an online self-management programme for people with persistent pain post-knee replacement (Kneed)

ObjectiveModerate to severe persistent pain can affect up to 25% of people after a knee replacement for osteoarthritis. The aim of the trial was to test the feasibility of implementing Kneed, a novel digital pain rehabilitation self-management programme.DesignProspective, two group parallel randomised pilot study.SettingOnline in Australia.ParticipantsAdults with persistent pain rated as ≥4/10 in the operated knee more than 3 months post-knee replacement for osteoarthritis.InterventionThe Kneed group were provided with 8 weeks of access to a digital pain rehabilitation self-management programme and compared to usual care.Main measuresRecruitment, acceptability, usability and limited efficacy with descriptive statistics.ResultsSixty participants, mean age 68.7 years, 75% female, 66.7% retired and 43% living outside metropolitan areas, were recruited between 15 October and 19 December, 2024 via social media advertising with 418 online eligibility surveys performed. There were 190 (45.5%) deemed potentially eligible; 82 (19.6%) left contact details and 60 (14.4%) consented. At 8 weeks, there were 48 (80%) participants remaining in the trial (20 Kneed (64.5%), 28 usual care (96.6%)). A majority of the Kneed group found the Kneed programme acceptable, would use it again and found that it helped them effectively manage pain and function.ConclusionIt is feasible to recruit and retain older Australians with moderate to severe knee pain post-knee replacement for a trial testing a digital pain rehabilitation self-management programme. A larger trial is indicated to further test the clinical effectiveness of Kneed to reduce pain and improve function.