# Effects of a Home-Based Prehabilitation Program on Biomarkers and Hospital Outcomes in Total Knee Arthroplasty: A Protocol for a Randomized Controlled Trial **Authors:** Gustavo Halmenschlager, Ana Leal, José Carlos Albarello, Yan Razuck, Thiago Lemos PMC · DOI: 10.7759/cureus.87061 · Cureus · 2025-06-30 ## TL;DR This study tests a home-based prehabilitation program for knee replacement patients to see if it improves recovery and reduces hospital stays. ## Contribution The study introduces a scalable, home-based prehabilitation protocol with remote supervision for TKA patients. ## Key findings - The program will assess changes in inflammatory and coagulation biomarkers. - It will evaluate hospital length of stay and postoperative complications. - Remote supervision may improve accessibility for prehabilitation in large healthcare systems. ## Abstract 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. ## Linked entities - **Proteins:** CRP (C-reactive protein), IL6 (interleukin 6) ## Full-text entities - **Genes:** IGF1 (insulin like growth factor 1) [NCBI Gene 3479] {aka IGF, IGF-I, IGFI, MGF}, GLB1 (galactosidase beta 1) [NCBI Gene 2720] {aka EBP, ELNR1, MPS4B}, BAX (BCL2 associated X, apoptosis regulator) [NCBI Gene 581] {aka BCL2L4}, FNDC5 (fibronectin type III domain containing 5) [NCBI Gene 252995] {aka FRCP2, irisin}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, CYCS (cytochrome c, somatic) [NCBI Gene 54205] {aka CYC, HCS, THC4}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, PLAT (plasminogen activator, tissue type) [NCBI Gene 5327] {aka T-PA, TPA}, FGB (fibrinogen beta chain) [NCBI Gene 2244] {aka HEL-S-78p}, IL12B (interleukin 12B) [NCBI Gene 3593] {aka CLMF, CLMF2, IL-12B, IMD28, IMD29, NKSF}, PRG4 (proteoglycan 4) [NCBI Gene 10216] {aka CACP, HAPO, JCAP, MSF, SZP}, SERPINE1 (serpin family E member 1) [NCBI Gene 5054] {aka PAI, PAI-1, PAI1, PLANH1}, IL4 (interleukin 4) [NCBI Gene 3565] {aka BCGF-1, BCGF1, BSF-1, BSF1, IL-4} - **Diseases:** bacterial infections (MESH:D001424), TKA (MESH:D007718), Arthritis (MESH:D001168), sore throat (MESH:D010612), frailty (MESH:D000073496), ischemia (MESH:D007511), postoperative pain (MESH:D010149), knee osteoarthritis (MESH:D020370), orthopedic (MESH:D009140), bone loss (MESH:D001847), injuries (MESH:D014947), chronic (MESH:D002908), Cognitive impairments (MESH:D003072), acute infections (MESH:D000208), stiffness (MESH:C566112), anxiety (MESH:D001007), viral (MESH:D014777), cough (MESH:D003371), cartilage degeneration (MESH:D002357), anemia (MESH:D000740), sleep deprivation (MESH:D012892), pain (MESH:D010146), OA (MESH:D010003), infection (MESH:D007239), inflammation (MESH:D007249), muscle weakness (MESH:D018908), coagulation (MESH:D001778), fever (MESH:D005334), thromboembolic (MESH:D013923), tissue injury (MESH:D017695) - **Chemicals:** D (MESH:D003903), lipid (MESH:D008055), Lactate (MESH:D019344) - **Species:** Homo sapiens (human, species) [taxon 9606] - **Mutations:** P150C ## Full text _Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12311249/full.md ## Figures 3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12311249/full.md ## References 34 references — full list in the complete paper: https://tomesphere.com/paper/PMC12311249/full.md --- Source: https://tomesphere.com/paper/PMC12311249