Implementation of Neuromuscular Electrical Stimulation after Total Knee Arthroplasty

This study aims to improve rehabilitation outcomes for patients undergoing total knee arthroplasty (TKA) by evaluating the effectiveness of neuromuscular electrical stimulation (NMES) in reducing quadriceps strength loss, a common issue following surgery. TKA results in significant muscle weakness, particularly in the quadriceps, which can impair functional performance and contribute to long-term disability. While NMES has been shown to reduce quadriceps strength loss in controlled settings, it is underutilized in real-world clinical practice. This study will conduct a cluster randomized trial across two healthcare systems (Intermountain Health and UCHealth) with 30 outpatient physical therapy clinics. The trial will compare outcomes between patients who receive NMES-enhanced rehabilitation and those who receive standard rehabilitation. By evaluating the effectiveness of NMES and identifying implementation strategies to promote its integration into clinical practice, this research aims to improve strength, function, and quality of life for millions of Americans undergoing TKA each year. Ultimately, the study will provide evidence supporting the systematic use of NMES in TKA rehabilitation and offer tools for healthcare systems to adopt and scale its usage.