Effect of AI-Assisted Anatomical Visualization on Anxiety and Kinesiophobia in Knee Arthroplasty Patients

NCT07545447 | Not Yet Recruiting

• 1 other identifier: AIKNEE-2026-01
• Study Type: interventional
• Target: 150
• Locations: 0 countries
• Sites: N/A

Brief Summary

Total knee arthroplasty (TDA) is an effective surgical method applied to reduce pain, improve joint function, and enhance quality of life in patients with advanced osteoarthritis or joint degeneration. However, it is known that surgical success is not limited to the operation itself; pre- and post-operative processes are at least as important as the surgical technique. In particular, active patient participation, early mobilization, and adherence to exercises during the rehabilitation period directly affect treatment outcomes. Patient education plays a critical role in this process. Accurate and sufficient information reduces patients' anxieties about the surgical process and increases their confidence in the recovery process. It also prevents the development of kinesiophobia (fear of movement), supporting patients in participating in physical activity more quickly and safely. Patient education can be provided through various methods. Traditional approaches include face-to-face clinical training, verbal information provided by nurses or physiotherapists, written brochures, and visual materials. While this standard clinical training is effective in conveying basic information, it may have limitations in patients' ability to recall information and adapt it to daily life. In recent years, technology-based training methods have gained increasing importance. In particular, AI-assisted video-based anatomical visualization training can present the structure of the surgery, the placement of the prosthesis, and the movement mechanism to patients in a more understandable and visual way. Such interactive and visually rich training offers advantages in terms of increasing patients' knowledge levels, reducing anxiety, and strengthening their participation in treatment. In conclusion, success after total knee arthroplasty depends not only on the surgical intervention but also on effective patient education. Comparing standard clinical training with AI-assisted visual training methods constitutes an important area of research for improving patient outcomes.

Conditions

Knee Osteoarthritis; Total Knee Arthroplasty

Keywords

Total Knee Arthroplasty; AI-Assisted Training; Anxiety; Kinesiophobia

Outcome Measures

Primary Outcomes (1)

• Anxiety Level

  State Anxiety - (STAI-I): The State-Trait Anxiety Inventory (STAI), developed by Spielberger and adapted into Turkish by Öner and Le Compte, will be used to assess anxiety levels. The STAI consists of 40 items and two subscales: State Anxiety and Trait Anxiety. In this study, the State Anxiety subscale will be used to measure participants' current anxiety levels. The State Anxiety subscale is a 4-point Likert-type scale ranging from 1 (not at all) to 4 (completely). Higher scores indicate higher levels of anxiety. The scale includes both positively and negatively worded items, which are reverse-scored accordingly. A constant value of 50 is added to the total score to obtain the final score.

  postoperative day 1, discharge day ( postoperative day 3-4) and postoperative day 14

Secondary Outcomes (1)

• Kinesiophobia Level

  Kinesiophobia will be evaluated using a validated kinesiophobia scale at three time points: postoperative day 1, discharge day ( postoperative day 3-4) and postoperative day 14

Study Arms (3)

Standard Clinical Education

ACTIVE COMPARATOR

Participants in this arm will receive standard clinical education as part of routine care. This includes face-to-face verbal education provided by healthcare professionals, written informational materials, and conventional preoperative and postoperative counseling regarding total knee arthroplasty and rehabilitation exercises.

Behavioral: Standard Clinical Education

Video-Supported Education

ACTIVE COMPARATOR

Participants in this arm will receive standard clinical education combined with structured video-supported educational content. The videos will demonstrate the surgical procedure, prosthesis function, and postoperative rehabilitation exercises in a visual format to enhance understanding and retention of information.

Behavioral: Video-Supported Education

AI-Assisted Anatomical Visualization Training

EXPERIMENTAL

Participants in this arm will receive standard clinical education in addition to AI-assisted anatomical visualization training. This intervention uses artificial intelligence-supported interactive video content to provide enhanced anatomical visualization of the knee joint, prosthesis placement, and functional movement. The aim is to improve patient understanding, reduce anxiety, and decrease kinesiophobia related to total knee arthroplasty.

Behavioral: AI-Assisted Anatomical Visualization Training

Interventions

Standard Clinical Education BEHAVIORAL

Participants receive routine preoperative and postoperative education including verbal counseling by healthcare professionals, written informational materials, and standard physiotherapy guidance regarding total knee arthroplasty and rehabilitation exercises.

Standard Clinical Education

Video-Supported Education BEHAVIORAL

Participants receive standard clinical education combined with structured educational videos demonstrating total knee arthroplasty procedure, prosthesis function, and rehabilitation exercises to improve patient understanding and information retention.

Video-Supported Education

AI-Assisted Anatomical Visualization Training BEHAVIORAL

Participants receive standard clinical education in addition to AI-assisted anatomical visualization training using interactive video-based content. This intervention provides enhanced visualization of knee joint anatomy, prosthesis placement, and postoperative functional movement to improve understanding and reduce anxiety and kinesiophobia.

AI-Assisted Anatomical Visualization Training

Eligibility Criteria

• Age: 55 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 55 years and older
• Patients scheduled for elective total knee arthroplasty due to knee osteoarthritis
• Able to understand and communicate in Turkish
• Willing to participate in the study and provide written informed consent
• No prior total knee arthroplasty on the study knee
• Cognitively able to complete questionnaires and follow study procedures

You may not qualify if:

• Patients scheduled for revision total knee arthroplasty
• Patients with active infection
• Presence of severe neurological or psychiatric disease (conditions that would prevent reliable application of scales)
• Severe visual or hearing loss
• Diagnosed dementia or cognitive impairment
• Individuals who refused to participate in the study

Sponsors & Collaborators

• Ataturk University: lead

MeSH Terms

Conditions

Osteoarthritis, Knee; Anxiety Disorders; Kinesiophobia

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Mental Disorders; Phobic Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Munzur University

Model Details: This study is designed as a three-arm parallel-group randomized controlled trial. Participants will be randomly assigned to one of three groups: standard clinical education, video-supported education, or AI-assisted anatomical visualization training. Each group will receive its assigned intervention independently, without crossover between groups. Outcomes will be compared between groups to evaluate the effectiveness of different educational approaches on anxiety and kinesiophobia in patients undergoing total knee arthroplasty.

Study Record Dates

• First Submitted: April 15, 2026
• First Posted: April 22, 2026
• Study Start (Estimated): May 15, 2026
• Primary Completion (Estimated): September 15, 2026
• Study Completion (Estimated): November 15, 2026
• Last Updated: April 22, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share