Digital Technology-Based Interventions on Pain and Function in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Background: Digital technologies have emerged as promising tools for managing knee osteoarthritis (KOA).This study aimed to systematically review and comprehensively synthesize evidence regarding digital technology-based interventions for KOA, with a focus on classifying digital interventions and evaluating their effectiveness.Methods: PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched from inception to May 25, 2024.Randomized controlled trials evaluating digital technology-based interventions for patients with KOA reporting pain and function outcomes were systematically reviewed.Standardized mean differences (SMDs) were pooled, and subgroup analyses were performed by intervention type.Results: Twenty-three studies were included.Digital interventions significantly reduced pain (SMD -0.57; 95% CI -0.83 to -0.32) and improved function (SMD -0.38; 95% CI -0.53 to -0.24) in patients with KOA.Subgroup analyses demonstrated large effect estimates for pain and function with both online-and app-based real-time exercise coaching and monitoring (pain: SMD -1.34, 95% CI -2.62 to -0.07; function: SMD -1.10, 95% CI -1.38 to -0.82) and simple education delivered via mobile application or video conferencing (pain: SMD -0.93, 95% CI -1.83 to -0.03; function: SMD -0.92, 95% CI -1.40 to -0.44).In contrast, telephone-based remote exercise coaching and monitoring demonstrated small effects on pain and function, whereas remote physical activity motivation delivered via telephone or text messages yielded a small but statistically significant effect on function only.Conclusion: Digital interventions are effective for alleviating pain and improving function in patients with KOA by offering scalable and accessible strategies for the conservative management of KOA.