Virtual arthroplasty follow-up: five-year data from a district general hospital

Area of Science:

• Orthopedic Surgery
• Health Services Research

Background:

• Routine follow-up after hip and knee arthroplasty is recommended to detect asymptomatic loosening and enhance patient satisfaction.
• Traditional clinic appointments for arthroplasty follow-up incur significant financial and time costs.
• Virtual assessment methods offer a potential alternative to in-person follow-up appointments.

Purpose of the Study:

• To evaluate the effectiveness and safety of a virtual arthroplasty clinic for lower limb joint replacements.
• To assess the impact of virtual follow-up on patient outcomes and resource utilization.

Main Methods:

• Patients undergoing hip and knee arthroplasty at West Suffolk Hospital were followed up using questionnaires at 1 and 5 years postoperatively, with subsequent 5-yearly intervals.
• A retrospective review of patients assessed between 2011 and 2015 using the virtual assessment process was conducted.
• Outcomes, including recalls and subsequent interventions, were examined based on questionnaire responses and imaging.

Main Results:

• Over 5,380 patients were eligible for assessment, with compliance rates of 77% for hips and 83% for knees.
• Virtual review led to 4,219 avoided clinic appointments, with no documented admissions due to missed complications.
• For hip arthroplasty, 10 patients were recalled, with 5 undergoing revision surgery. For knee arthroplasty, 56 recalls occurred, with 5 subsequent revisions, 30 discharges, and 18 referrals.

Conclusions:

• A virtual arthroplasty clinic model effectively reduces the need for routine in-person follow-up appointments.
• This virtual approach maintains safe patient care standards following hip and knee arthroplasty.
• Virtual clinics offer a viable solution for optimizing resource allocation in arthroplasty follow-up.