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

Objective: Moderate 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. Design: Prospective, two group parallel randomised pilot study. Setting: Online in Australia. Participants: Adults with persistent pain rated as ≥4/10 in the operated knee more than 3 months post-knee replacement for osteoarthritis. Intervention: The Kneed group were provided with 8 weeks of access to a digital pain rehabilitation self-management programme and compared to usual care. Main measures: Recruitment, acceptability, usability and limited efficacy with descriptive statistics. Results: Sixty 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. Conclusion: It 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.