Effectiveness, Patient Satisfaction and Cost Reduction of Virtual Joint Replacement Clinic (VJRC) Follow-Up of Hip and Knee Replacement.

El Ashmawy, Abd-Allah; Dowson, Kathleen; El-Bakoury, Ahmed; Hosny, Hazem A.H.; Yarlagadda, Rathan; Keenan, Jonathan

Abstract Background Total hip (THR) and knee (TKR) replacements are increasingly performed operations and routine follow-up places huge demands on orthopedic services. This study investigates the effectiveness, patients’ satisfaction and cost reduction of Virtual Joint Replacement Clinic (VJRC) follow-up of THR and TKR patients in a university hospital. VJRC are especially valuable when in-person appointments are not advised or feasible such as during the COVID-19 pandemic. Methods 1749 patients who were invited for VJRC follow up for knee or hip arthroplasty from January 2017 to December 2018 were included in this retrospective study. Patients were referred to VJRC after their 6-week post-operative review. Routine VJRC postoperative review was undertaken at 1, 7 years and then 3 yearly thereafter. We evaluated the VJRC patient response rate, acceptability and outcome. Patient satisfaction was measured in a subgroup of patients using a satisfaction survey. VJRC costs were calculated compared to face-to-face follow up. Results The VJRC had a 92.05 % overall response rate. Only 7.22 % required further in-person appointments with only 3% being reviewed by an orthopedic consultant. VJRC resulted in an estimated saving of £43,644 per year at our institution. The patients’ satisfaction survey showed that 89.29% of the patients were either satisfied or very satisfied with VJRC follow-up. Conclusions VJRC follow-up for hip and knee arthroplasty patients is an effective alternative to in-person clinic assessment which is accepted by patients, has high patient satisfaction and can reduce the cost to both health services and patients.