Applying the Knowledge-to-Action Framework to Implement and Evaluate an Evidence-Based Functional Exercise Program for Elderly Patients After Total Knee Arthroplasty: A Mixed-Methods Study.

Purpose: This study aimed to develop a systematic, evidence-based rehabilitation intervention tailored for elderly patients undergoing TKA, informed by stakeholders, and evaluate its impact on patient outcomes. Patients and Methods: Guided by the Knowledge-to-Action (KTA) Framework, this study comprised two sequential phases. In the knowledge creation phase, we systematically synthesized evidence through comprehensive retrieval, critical appraisal, and integration of high-quality rehabilitation programs for elderly patients undergoing TKA from domestic and international literature. During the action cycle phase, expert panel discussions and stakeholder interviews were conducted to identify barriers and facilitators of implementation, culminating in the co-development of a finalized intervention program. A quasi-experimental study was subsequently implemented to assess its preliminary efficacy in this target population. Results: Fourteen high-quality sources were synthesized to form 17 evidence-based recommendations across six dimensions. Through expert panels and stakeholder interviews, a structured rehabilitation program was developed, addressing key barriers and implementation strategies. In the subsequent quasi-experimental study (n = 60), patients in the intervention group showed significantly better postoperative pain control, range of motion, and knee function compared to controls (all P < 0.05), with no baseline differences between groups. Conclusion: The evidence-based rehabilitation program significantly enhanced functional recovery parameters, and pain control efficacy compared to standard care. Implementation of this structured intervention framework demonstrates clinically meaningful improvements in early postoperative outcomes following TKA.