## 4 Discussion
These results, as indicated by the literature, suggest that patients with greater preoperative pain experience an improvement in pain after surgery but functional status may not improve the quality of patients with lower preoperative pain [39]. Considering HBR, there is greater concern regarding adherence to exercise prescription, compared with CBR. In this regard, [PERSON] et al. [40] found a strong association between adherence and exercise and functional outcomes. HBR requires specific assessment, and it is also important to have a network of primary-care and home-care programs that can establish the entire program; there may be some initial difficulties, but HBR patients have reported higher levels of satisfaction [30]. Moreover, [PERSON] et al. [33] reported that HBR patients would prefer any future therapy to be home-based because they had a positive experience with this type of therapy program. In our study, patients reported 100% adherence to the rehabilitation protocol carried out at home. The daily report was effective in providing feedback on the patient; this included both the general conditions and the execution of the scheduled program. The report was enabled patients to understand if they were improving, and the visits of the physiotherapist, at 15 days and a month after surgery, allowed any improvement to be evaluated. The telephone report was effective in monitoring the patient, both in requesting protocol explanations and in clinical monitoring. In this context, a study by [PERSON] et al. [41] reported that telephone follow-up increased short-term self-efficacy and also required fewer follow-up visits. We also reported the complications that occurred in the short-term follow-up. A surgical wound problem was reported by single patients in both the HBR and CBR groups. The patient who underwent HBR was referred to the surgeon who performed TKA; this surgeon then performed an ultrasound aspiration of the joint fluid which was analyzed for a microbiological assessment. Following the negativity of the analysis, the patient carried out medical therapy and used taping. Differently, in the case of the patient in the CBR group with a similar wound complication, the ultrasound was performed without the removal of liquid, and empirical, broad-spectrum antibiotic therapy was administered according to the physician of the clinic. After one month, the patient was referred to the surgeon who suspended the antibiotic therapy. After one week this surgeon performed a collection of joint fluid that proved negative for bacterial growth. Some authors advocate that CBR can lead to an earlier detection of adverse events in the early postoperative period, while others suggest that patients who are referred to the surgeon should better follow the guidelines than those referred to general doctor without experience in the field. Studies in the literature [11; 42] involving comparisons in terms of adverse reactions have reported no statistically significant differences between the two groups. [PERSON] et al. [43] conducted a study on 87 patients who were monitored telematically via an app during rehabilitation after TKA. This app sends an alert to a clinician when the patients answer the daily questions. Interestingly, 85% of the alerts sent by the patient were managed in telemedicine, avoiding consultations; the authors suggested that the overall low complication rate was due to the rapid dispatch of the alert. Moreover, immediate medical responses through the app may have been a factor in preventing more serious complications. In our study, the patients sent a daily report on their physical condition to the physiotherapist; if the answers in the report showed alerts or a worsening of clinical condition, the patient was recalled for a check and referred to the orthopedic surgeon if necessary. In our study, these adverse events were not related to the type of physiotherapy program performed but they did allow us to assess the benefit of daily monitoring, enabling an immediate response and intervention.