Virtual Examination Techniques, Clinical Effectiveness, and Future Directions of Telemedicine in Orthopedic Practice:...

Telemedicine adoption has made notable changes in orthopedic practice. It was greatly expanded with the COVID-19 pandemic, with the adoption across subspecialties offering comparable diagnostic accuracy, patient satisfaction, and safety to traditional visits. This narrative review summarizes the current applications of telemedicine and future directions in orthopedic telemedicine. Virtual examinations for the elbow, shoulder, hip, and knee have been successfully modified for remote assessment. The modifications of some tests now allow patients to perform self-tests under physician guidance using household tools. Randomized controlled trials (RCTs) demonstrate that telehealth consultations are not inferior to in-person evaluations in clinical decision-making. Limitations include the inability to replicate certain hands-on maneuvers, disparities in digital access among minority and low-income populations, and variable patient adherence. To optimize remote care, standardized telehealth protocols, improved image transmission, and targeted patient preparation are required. Artificial intelligence (AI) and large language models (LLMs) promise to enhance virtual care. Telemedicine is positioned to become a permanent, high-quality complement to in-person orthopedic practice, expanding global access to efficient and patient-centered musculoskeletal healthcare.