Background: Total hip and knee arthroplasty are common procedures for end-stage osteoarthritis, with rehabilitation playing a central role in functional recovery. Conventional face-to-face programs are often limited by accessibility, costs, and logistical barriers. Digital telerehabilitation has been increasingly investigated as an alternative. This review aims to summarize current evidence on its effectiveness, patient-reported outcomes, satisfaction, and economic impact. Materials and Methods: A narrative review was conducted using Medline, Web of Science, and Scopus up to April 2025. Randomized controlled trials and longitudinal studies evaluating telerehabilitation after total hip or knee arthroplasty were included. Data were extracted on functional performance, pain, autonomy, quality of life, patient satisfaction, and cost-effectiveness. Results: Across multiple RCTs, telerehabilitation produced functional outcomes generally comparable to conventional rehabilitation, with some studies reporting superior short-term improvements. For example, in a retrospective trial, Timed Up and Go improved by −8.0 ± 2.6 s in the digital group versus −4.9 ± 2.5 s with standard care (p < 0.01). Tablet-assisted programs reduced Five Times Sit-to-Stand times to 11.7 s at 6 months compared with 14.7 s in controls (p = 0.05). In hip arthroplasty, digital rehabilitation resulted in higher active flexion (97.4° vs. 89.9°, p = 0.018) and abduction (51.7° vs. 43.8°, p = 0.024). Quality-of-life measures, such as EQ-5D VAS, also showed improvements (82.9 ± 4.3 vs. 68.7 ± 4.6 at 6 months). Some studies reported higher patient satisfaction, for instance, a VR-based RCT found GPE at day 15 of 4.76 ± 0.43 in the intervention group versus 3.96 ± 0.65 in controls (p < 0.001). Conclusions: Telerehabilitation after hip and knee arthroplasty appears to produce short-term functional and patient-reported outcomes comparable to conventional rehabilitation in selected populations. Evidence of superiority is limited and heterogeneous, and long-term effectiveness, equity, and cost-effectiveness remain uncertain. Heterogeneity in protocols and digital literacy barriers highlight the need for standardized guidelines and further independent validation.

Background: Pigmented villonodular synovitis (PVNS) is a rare, proliferative disorder of the synovium that predominantly affects the knee. Traditional treatment involves surgical resection; however, the high recurrence rates have prompted the exploration of alternative, minimally invasive treatments. This case report presents the novel use of genicular artery embolization (GAE) with imipenem/cilastatin as a therapeutic intervention. Case presentation: We present a case of a 52-year-old male with a 5-month history of progressive left-knee pain and swelling. Magnetic resonance imaging (MRI) suggested PVNS, which was confirmed through synovial biopsy. Because of concerns about surgical recovery and recurrence risk, the patient opted for GAE with imipenem/cilastatin over traditional synovectomy. This technique, employing the antibiotic’s anti-angiogenic and anti-inflammatory properties, was administered under local anesthesia without complications. Results: Post-procedural assessments demonstrated rapid and sustained symptom relief. At the 1-month follow-up, the patient’s Visual Analog Scale (VAS) pain score decreased from 7/10 to 3/10, and their Knee Injury and Osteoarthritis Outcome Score (KOOS) and SF-36 health survey scores indicated significant functional improvement. By the 6-month follow-up, the VAS had reached 0/10; the KOOS value reflected near-complete functional recovery; and MRI confirmed reduced synovial hypertrophy and absence of recurrence. No complications were observed. Discussion: GAE with imipenem/cilastatin shows potential as an effective alternative to surgery for PVNS, particularly in patients at risk of surgical complications or recurrence. While the preliminary findings are promising, the limitations include the case’s single-subject design and the need for extended follow-up to determine long-term outcomes and recurrence rates. Further studies comparing GAE with traditional surgical approaches are needed to assess its broader applicability in PVNS management. Conclusion: GAE with imipenem/cilastatin offers a promising, minimally invasive approach for PVNS, providing significant symptom relief and functional recovery with minimal complications. Although long-term studies are needed, this technique could serve as a viable alternative for patients with PVNS, especially those contraindicated for surgery.

Background: Total hip and knee arthroplasty are widely performed procedures for end-stage osteoarthritis, with postoperative rehabilitation crucial in achieving optimal outcomes. Traditional in-person rehabilitation, however, faces limitations such as accessibility, cost, and logistical barriers. In this context, telerehabilitation has emerged as a promising digital alternative.Objective: This narrative review aims to synthesize current literature on telerehabilitation following total joint arthroplasty, evaluating its clinical effectiveness, cost-efficiency, patient satisfaction, and implementation challenges in comparison to conventional rehabilitation.Materials and Methods: A comprehensive literature search was conducted in Medline, Web of Science, and Scopus through April 2025. Studies included randomized controlled trials and longitudinal research involving telerehabilitation in total knee or hip arthroplasty. Data were extracted on outcomes, complications, technology integration, and patient-reported measures.Results: Evidence suggests that telerehabilitation—delivered via mobile apps, wearable sensors, virtual reality, and AI-enhanced platforms—can achieve functional outcomes comparable to traditional rehabilitation in terms of pain reduction, range of motion, and muscle strength. Patient satisfaction, adherence, and health-related quality of life are often superior in digitally supported programs, especially when remote coaching is included. Cost analyses indicate favorable economic benefits. However, challenges persist related to digital literacy, infrastructure, regulatory gaps, and the need for standardized protocols.Conclusion: Telerehabilitation represents a clinically valid, economically sustainable, and patient-centered alternative to traditional rehabilitation after total joint arthroplasty. Future research should focus on long-term outcomes, optimization of remote monitoring tools, and development of evidence-based implementation guidelines.

Background: Chronic pain after unicompartmental knee arthroplasty (UKA) represents a significant clinical issue, often unrelated to mechanical causes and resistant to standard therapies. This work combines a narrative review and a case report to explore the pathophysiological mechanisms underlying persistent post-UKA pain and to propose genicular artery embolization (GAE) with Imipenem/Cilastatin (IPM/CS) as a novel minimally invasive treatment option. Methods: A comprehensive literature review was conducted to analyze current diagnostic and therapeutic approaches to chronic post-UKA pain, with emphasis on vascular and inflammatory mechanisms. Additionally, a patient with chronic lateral knee pain refractory to conservative management underwent selective GAE targeting hypervascularized genicular branches. Results: Following the procedure, the patient experienced substantial and sustained pain reduction, functional improvement, and no complications. The literature supports synovial neovascularization as a potential pain generator and confirms the safety of IPM/CS due to its transient embolic effect and preservation of normal perfusion. Conclusions: The combination of literature review and clinical evidence suggests that GAE may represent a promising therapeutic alternative for chronic post-UKA pain. Further studies are needed to confirm its efficacy, long-term outcomes, and appropriate indications within this challenging clinical setting.

Background: Osteoarthritis involves the degeneration of cartilage, subchondral bone, and the synovial membrane, often associated with rotator cuff (RC) tears, causing pain and functional limitations. While non-surgical treatments can provide relief, surgery is sometimes necessary. Autologous adipose-derived mesenchymal stem cells (ADMSCs) have shown promise in tissue repair. Objective: This study compared clinical outcomes between patients treated with arthroscopic RCR alone and those treated with RCR combined with intra-articular AdMSC injection. Methods: This retrospective study included 61 patients. Group A (n = 30) underwent standard RCR, while Group B (n = 31) received RCR combined with intra-articular ADMSC injections. Participants had comparable baseline age, BMI, height, CMS, and VAS scores. Shoulder function was assessed using the Constant–Murley Score, and pain intensity was assessed using the visual analog scale at baseline, 3, 6, and 12 months. Statistical significance was set at p < 0.05. Results: At 3 months, Group B showed lower VAS scores than Group A (13.09 ± 8.34 vs. 25.14 ± 13.57, p < 0.001), while CMSs did not differ significantly (70.55 ± 23.46 vs. 63.01 ± 24.33, p = 0.223). At 6 months, Group B showed better VAS and CMSs than Group A (VAS: 5.31 ± 4.38 vs. 23.74 ± 15.72, p < 0.001; CMS: 83.29 ± 18.98 vs. 65.66 ± 11.58, p < 0.001). At 12 months, Group B maintained better VAS and CMSs than Group A (VAS: 4.45 ± 5.67 vs. 18.34 ± 12.65, p < 0.001; CMS: 85.55 ± 13.12 vs. 66.36 ± 9.38, p < 0.001). Conclusions: In this preliminary retrospective non-randomized cohort, AdMSC use as an adjunct to arthroscopic rotator cuff repair was associated with better pain and functional scores over 12 months. Because of the retrospective design and lack of imaging follow-up, these findings should be interpreted as clinical associations and require confirmation in randomized studies.