OBJECTIVES: Telerehabilitation after Total Knee Replacement (TKR) showed to be not inferior to standard rehabilitation (SR) in clinical outcomes in patients without complication related to TKR surgery. Both utilities and cost-utilities are currently unexplored for telerehabilitation. The aim of this economic evaluation was to assess the potential cost-utility of a mixed telerehabilitation-SR (TR-SR) versus SR programme. METHODS: A Markov model simulated the natural progression of TKR, assuming telerehabilitation is not influencing transition probabilities and HRQOL. Revision risk and utilities were calculated from patient-level data from the multicentre KAT trial, respectively employing parametric survival and linear regression models. Published literature provided the remaining state-transition probabilities; while rehabilitation and transportation costs were identified adopting Ita-NHS perspective and monetized employing Italian tariffs. The patients without complication were assigned to the TR-SR programme and received half of the sessions in SR and half in telerehabilitation regime. Patients with any complication followed the SR. Costs and effects were adjusted applying half-cycle correction and an annual discount rate of 3%. Probabilistic sensitivity analysis (PSA) described the parameters uncertainty and one-way sensitivity analysis assessed the robustness of our assumption for HRQOL.  RESULTS: Both SR and TR-SR were assessed using a cohort of 1000 patients with the KAT trial features (70 years old, 44% male and 19% had any complication). The mean±95%CI difference between TR-SR and SR was -215.33±€10.64 (the mean (SE) lifetime healthcare costs were €1,033.81 (€21.97) for SR and €818.44 (€13.82) for SR-TR). The mean (SE) lifetime QALY was 9.69 (0.003). If telerehabilitation at least will not decrease the utilities observed in SR, the probability that telereahabilitation is cost-saving (WTP:0€ per QALY) is 90%. CONCLUSIONS: SR-TR could be cost-effective for the Ita-NHS if it does not impair the patients’ HRQOL. Specific utilities for telerehabilitation after TKR and further sensitivity analyses are required to relax our assumptions.