Virtual and Augmented Reality for Post-Surgical Orthopaedic Rehabilitation: A Review of Emerging Digital Tools
DOI:
https://doi.org/10.55938/ijgasr.v5i1.239Keywords:
Virtual Reality, Augmented Reality, Orthopaedic Physiotherapy, Post-Surgical Recovery, Rehabilitation, Digital HealthAbstract
Post-surgical orthopaedic rehabilitation traditionally faces significant barriers, including low patient adherence and limited access to personalized care. This narrative review critically investigates the potential of VR and AR to transform recovery outcomes. Following a systematic PRISMA-based search strategy of literature from 2022 to 2025, this study evaluates the therapeutic mechanisms, clinical efficacy, and implementation challenges of these digital tools. This review compares the
established clinical efficacy of VR against emerging AR modalities in orthopaedic recovery. Both technologies leverage neuroplasticity, motor learning, and gamification to facilitate recovery. While technological barriers such as cybersickness and sensor accuracy persist, the integration of VR/AR with AI and telerehabilitation offers a promising paradigm shift toward accessible, data-driven orthopaedic care.
Downloads
References
Chunduri A and Aggarwal A. Multimodal pain management in orthopedic surgery. Journal of Clinical Medicine 2022; 11. DOI:10.3390/jcm11216386.
World Health Organization. Musculoskeletal conditions, 2025. URL https://www.who.int/ news-room/fact-sheets/detail/musculoskeletal-conditions.
Rabbani Sani G. Review of physiotherapy protocols for postoperative rehabilitation after orthopaedic surgeries, 2024. DOI:10.33545/30810604.2024.v1.i1.A.2.
Konnyu K, Thoma L, Cao W et al. Rehabilitation for total knee arthroplasty: A systematic review. American Journal of Physical Medicine and Rehabilitation 2022; 102: 19. DOI: 10.1097/PHM.0000000000002008.
Rhamelani P, Mahdhiya N, Yoviana I et al. Early mobilization in post-orthopedic surgery patients: A scoping review. Journal of Multidisciplinary Healthcare 2025; 18: 305–317. DOI: 10.2147/JMDH.S483232.
Kattan A, AlHemsi H, AlKhawashki A et al. Patient compliance with physical therapy following orthopedic surgery and its outcomes. Cureus 2023; 15: e37217. DOI:10.7759/cureus.37217.
Burns D, Boyer P, Razmjou H et al. Adherence patterns and dose response of physiotherapy for rotator cuff pathology. JMIR Rehabilitation and Assistive Technologies 2021; 8: e21374. DOI: 10.2196/21374.
Argent R, Daly A and Caulfield B. Patient involvement with home-based exercise programs. JMIR mHealth and uHealth 2018; 6: e47. DOI:10.2196/mhealth.8518.
Paladugu P, Kumar R, Ong J et al. Virtual reality-enhanced rehabilitation for improving musculoskeletal recovery after trauma. Journal of Orthopaedic Surgery and Research 2025; 20: 404. DOI:10.1186/s13018-025-05705-3.
Combalia A, Sanchez-Vives M and Donegan T. Immersive virtual reality in orthopaedics: A narrative review. International Orthopaedics 2024; 48: 21–30. DOI:10.1007/s00264-023-05911-w.
Moghadasi K, Isa M, Ariffin M et al. Biomedical implant materials and friction stir techniques. Journal of Materials Research and Technology 2022; 17: 1054–1121. DOI:10.1016/j.jmrt.2022.01.050.
Sood R. Effectiveness of non-invasive physiotherapy techniques in managing chronic temporomandibular disorder pain. Journal of Oral and Maxillofacial Anesthesia 2025; 4. DOI: 10.21037/joma-24-28.
Goel S, Deshpande S, Jadawala V et al. Postoperative analgesics used in orthopedic practice. Cureus 2023; 15: e48750. DOI:10.7759/cureus.48750.
An J, Cheon S and Lee B. Combined balance exercise on knee rom and gait following total knee arthroplasty. Medicina 2024; 60: 1389. DOI:10.3390/medicina60091389.
Hardy M, Feehan L, Savvides G et al. Controlled motion alters musculoskeletal tissue properties. Journal of Hand Therapy 2023; 36: 269–279. DOI:10.1016/j.jht.2022.12.003.
Aprisunadi, Nursalam, Mustikasari et al. Effect of early mobilization on hip and lower extremity postoperative. SAGE Open Nursing 2023; 9. DOI:10.1177/23779608231167825.
Thomas A, Wojtys E, Brandon C et al. Muscle atrophy contributes to quadriceps weakness after acl reconstruction. Journal of Science and Medicine in Sport 2015; 19: 7. DOI:10.1016/j.jsams.2014. 12.009.
Mumbleau A, Schilaty N and Hewett T. Hip muscle inhibition after hip arthroscopy. International Journal of Sports Physical Therapy 2020; 15: 1222. DOI:10.26603/ijspt20201222.
De Vroey H, Claeys K et al. Kinesiophobia after knee replacement surgery. Journal of Clinical Medicine 2020; 9. DOI:10.3390/jcm9030738.
Harmer J, Wyles C, Duong S et al. Depression and anxiety associated with increased risk after arthroplasty. Bone and Joint Journal 2023; 105: 526–533. DOI:10.1302/0301-620x.105b5. bjj-2022-1123.r1.
Meng Y, Deng B, Liang X et al. Self-efficacy-enhancing interventions after total hip replacement. Journal of Orthopaedic Surgery and Research 2022; 17. DOI:10.1186/s13018-022-03116-2.
Bido J, Torres R, Kaidi A et al. Early readmission and revision after total joint arthroplasty. HSS Journal 2024; 20: 187–194. DOI:10.1177/15563316241230052.
Sadoghi P, Koutp A, Prieto D et al. Economic burden of revision hip and knee arthroplasties. Knee Surgery Sports Traumatology Arthroscopy 2025; 33. DOI:10.1002/ksa.12678.
Zuo Q, Zhao K, Dong B et al. Risk factors for surgical site infection in spinal surgery. BMC Musculoskeletal Disorders 2024; 25: 1–9. DOI:10.1186/s12891-024-08149-8.
Lucena-Anton D, Fernandez-Lopez J et al. Virtual and augmented reality versus traditional methods for teaching physiotherapy. European Journal of Investigation in Health Psychology and Education 2022; 12: 1780–1792. DOI:10.3390/ejihpe12120125.
Jeyaraman M, Jeyaraman N, Ramasubramanian S et al. Enhancing orthopedic rehabilitation: Impact of virtual reality technology. Journal of Orthopaedic Case Reports 2024; 14: 1–6. DOI: 10.13107/jocr.2024.v14.i04.4338.
Natarajan P, Fonseka R, Maharaj M et al. Continuous data capture of gait and mobility using wearable devices. Journal of Orthopaedic Surgery and Research 2023; 18: 1–14. DOI:10.1186/ s13018-023-04303-5.
Forsyth L, Ligeti A, Blyth M et al. Validity of wearable sensors for tka rehabilitation. Knee 2024; 51: 292–302. DOI:10.1016/j.knee.2024.10.006.
Drigas A and Sideraki A. Brain neuroplasticity leveraging virtual reality and bci technologies. Sensors 2024; 24: 5725. DOI:10.3390/s24175725.
Acuna Luna K, Hernandez-Rios E et al. Deep learning-enhanced motor training: Hybrid vr and exoskeleton system. Bioengineering 2025; 12: 331. DOI:10.3390/bioengineering12040331.
Alwashmi K, Meyer G, Rowe F et al. Enhancing learning outcomes through multisensory integration in vr. NeuroImage 2024; 285: 120483. DOI:10.1016/j.neuroimage.2023.120483.
Vuong T, Zhu K and Pastor A. Virtual reality as a pain control adjunct in orthopedics. Cureus 2024; 16: e66401. DOI:10.7759/cureus.66401.
Peng L, Zeng Y, Wu Y et al. Virtual reality-based rehabilitation after total knee arthroplasty. Chinese Medical Journal 2022; 135: 153–163. DOI:10.1097/cm9.0000000000001847.
Cortes-Perez I, Desdentado-Guillem J et al. Virtual reality therapy after acl injury: Systematic review. Knee Surgery Sports Traumatology Arthroscopy 2025; 33: 1736–1753. DOI:10.1002/ksa. 12477.
Chang W, Lee J, Hwang J et al. Digital healthcare rehabilitation after rotator cuff repair. Trials 2022; 23: 1–8. DOI:10.1186/s13063-022-06648-4.
Lim J, Yu H, Kim S et al. In-home augmented reality telerehabilitation after acl reconstruction. Orthopaedic Journal of Sports Medicine 2024; 12. DOI:10.1177/23259671241271729.
Gazendam A, Zhu M, Chang Y et al. Virtual reality rehabilitation after total knee arthroplasty. Knee Surgery Sports Traumatology Arthroscopy 2022; 30: 2548–2555. DOI: 10.1007/s00167-022-06910-x.
Majelan A, Shahani O et al. Proprioception and virtual reality exercises after acl reconstruction. BMC Musculoskeletal Disorders 2025; 26. DOI:10.1186/s12891-025-08823-5.
Li Y, Peng J, Cao J et al. Effectiveness of virtual reality in acl rehabilitation. PLoS One 2025; 20. DOI:10.1371/journal.pone.0314766.
Gianola S, Stucovitz E et al. Early vr-based rehabilitation in total knee arthroplasty. Medicine 2020; 99. DOI:10.1097/md.0000000000019136.
Pournajaf S, Goffredo M et al. Vr-based balance training after total knee replacement. Annals of Physical and Rehabilitation Medicine 2022; 65: 101609. DOI:10.1016/j.rehab.2021.101609.
Berton A, Longo U et al. Virtual reality, augmented reality and telerehabilitation psychological impact. Journal of Clinical Medicine 2020; 9: 2567. DOI:10.3390/jcm9082567.
Wang Q, Gao J, Zhu A et al. Patient engagement in mobile technology-based rehabilitation. Journal of Clinical Nursing 2025; 34: 3489–3503. DOI:10.1111/jocn.17802.
Schaumburg M, Imtiaz A, Zhou R et al. Immersive virtual reality for older adults. Ageing Research Reviews 2025; 109: 102771. DOI:10.1016/j.arr.2025.102771.
Kiani S, Rezaei I, Abasi S et al. Technical aspects of vr-based rehabilitation systems. BMC Musculoskeletal Disorders 2023; 24: 1–25. DOI:10.1186/s12891-022-06062-6.
Plavoukou T, Staktopoulos P et al. Virtual and augmented reality for chronic musculoskeletal rehabilitation. Bioengineering 2025; 12: 745. DOI:10.3390/bioengineering12070745.
Zhou S, Gromala D and Wang L. Ethical challenges of virtual reality interventions for chronic pain. Journal of Medical Internet Research 2023; 25: e49237. DOI:10.2196/49237.
Abedi A, Colella T, Pakosh M et al. Ai-driven virtual rehabilitation. NPJ Digital Medicine 2024; 7: 25. DOI:10.1038/s41746-024-00998-w.
Morri M, Ruisi R, Culcasi A et al. Effectiveness of telerehabilitation after orthopedic surgery. Telemedicine Reports 2024; 5: 78. DOI:10.1089/tmr.2023.0057.
Jung S, Zhou M, Ma J et al. Wearable body sensors integrated into virtual reality for rehabilitation. IEEE EMBS Conference 2024; DOI:10.1109/EMBC53108.2024.10782207.
Khan S, Shamsi S and Alyaemni A. Effect of ultrasound and exercise combined in chronic back pain. Indian Journal of Physiotherapy and Occupational Therapy 2013; 7: 197–201.
Zitti M, Regazzetti M, Federico S et al. Effectiveness of virtual reality for pain management in musculoskeletal disorders. Musculoskeletal Care 2025; 23: e70041. DOI:10.1002/msc.70041.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Sharick Shamsi, Akram Abdelhamid, Shabana Khan, Samiha Mohamed Ibrahim Abdelkader, Walaa M. Moslem, Osama Hamed Aljeheny, Amit Nagarwal, Komal
This work is licensed under a Creative Commons Attribution 4.0 International License.
