Can virtual consultations replace physical visits before knee arthroplasty? : a retrospective cohort study

Area of Science:

• Orthopedic Surgery
• Digital Health Innovations
• Patient Care Pathways

Background:

• Increasing demand for knee replacement surgeries necessitates efficient patient management.
• Virtual consultations offer a novel approach to streamline preoperative assessments.

Purpose of the Study:

• To evaluate the feasibility of virtual consultations as a substitute for in-person consultations in patients undergoing total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA).

Main Methods:

• A single-centre cohort study included patients with severe osteoarthritis undergoing virtual consultations as their sole preoperative contact.
• Inclusion criteria: Kellgren-Lawrence grade ≥ 3 and American Society of Anesthesiologists grade ≤ 2.
• Outcomes: proportion of patients scheduled for surgery, requiring in-person consultations, surgery completion, and conversion rates.

Main Results:

• Out of 303 patients, 32% were directly scheduled for surgery post-virtual consultation.
• 41% required an in-person consultation, and 27% were managed without surgery.
• 85% of directly scheduled surgeries proceeded as planned, with no UKA to TKA conversions.

Conclusions:

• Virtual consultations are a feasible option for selected knee arthroplasty patients, potentially replacing in-person preoperative assessments.
• Further research is recommended to assess patient safety and patient-reported outcomes.