# Improving Rehabilitation for Veterans After Total Knee Arthroplasty Using Individualized Recovery Trajectories

> **NIH VA I01** · VA EASTERN COLORADO HEALTH CARE SYSTEM · 2022 · —

## Abstract

Rehabilitation after total knee arthroplasty (TKA) is typically generic and inefficient; most patients receive the
same contents and dosage of rehabilitation regardless of their individual needs, preferences, or expectations.
This generic treatment paradigm will be unsustainable in the Veterans Health Administration (VHA) as the
demand for TKA surgery and postoperative care increase exponentially in the near future. Without new
strategies to improve the efficiency of TKA rehabilitation, organizations like the VHA will struggle to meet and
pay for this surging demand, and Veterans may be denied timely access to the postoperative care they need
for optimal recovery. We have developed an innovative new clinical decision support (CDS) tool to optimize
efficiency in TKA rehabilitation. Using the actual recovery data of similar historical patients, the tool can predict
the recovery trajectory for new patients after TKA. This allows clinicians to (1) allocate rehabilitation resources
based upon individual need, (2) identify Veterans at risk for suboptimal outcomes early after surgery, (3) tailor
treatment strategies to Veterans’ unique goals and clinical presentation, and (4) monitor Veterans’ recovery
relative to expected throughout postoperative rehabilitation. In this project, we propose to expand the CDS
tool’s capabilities by establishing utilization guidelines based upon individual Veteran’s predicted recovery (Aim
1). These guidelines will be established by expert consensus in a three round Delphi process. Subsequently,
we will test the CDS tool’s impact on Veteran’s functional recovery and rehabilitation utilization in four VHA
outpatient physical therapy clinics using a pre-post design (Aim 2). We will compare patient-reported function
(Lower Extremity Functional Scale) and physical therapy visit utilization between cohorts of Veterans treated
with and without the CDS tool. Additionally, we will gather data from participating VHA clinicians and Veterans
regarding the translation of our tool into clinical practice to assess its readiness for dissemination throughout
the VHA (Aim 3). This will include qualitative data from participant focus groups and quantitative process data
regarding the tool’s utilization. Ultimately, we expect this study will serve as a template for expanding our tool’s
capabilities into numerous VHA populations in rehabilitation and beyond.

## Key facts

- **NIH application ID:** 10424875
- **Project number:** 1I01RX003770-01A1
- **Recipient organization:** VA EASTERN COLORADO HEALTH CARE SYSTEM
- **Principal Investigator:** Jennifer E. Stevens-Lapsley
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10424875

## Citation

> US National Institutes of Health, RePORTER application 10424875, Improving Rehabilitation for Veterans After Total Knee Arthroplasty Using Individualized Recovery Trajectories (1I01RX003770-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10424875. Licensed CC0.

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