Lovelock Thomas, O'Brien Michael, Young Ian, Broughton Nigel
Department of Surgery, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia.
Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
ANZ J Surg. 2018 Jun 27. doi: 10.1111/ans.14752.
We use a 'Virtual Clinic' for follow up of hip and knee replacement patients. The aim of this study was to investigate patient compliance, pain and function, revision rates and surgeon experience using this system.
All hip and knee replacements conducted from 2000 onwards were suitable for 'Virtual Clinic' review. Between July 2014 and December 2016, all patients due for follow up (at 1, 5 and 7 years post-operatively, or biennially thereafter) were mailed an Oxford Hip or Knee Score and a request for a radiograph. A surgeon reviewed the questionnaire and radiograph and decided whether face-to-face review was necessary. We calculated compliance as the percentage of eligible patients who completed the 'Virtual Clinic'. We used retrospective review of medical records for all clinic participants to analyse Oxford scores, disposition following appointment, and revision rates. We reviewed all clinic participants in December 2017 to identify any further revisions. Surgeon feedback was assessed by emailed survey.
A total of 2076 patients were due for follow up. 1405 patients were contactable, and 710 completed the process. We calculated a 36% compliance rate. Surgeons decided 162 (23%) patients with a mean Oxford score of 24.2 required face-to-face assessment. This identified 13 patients needing revision. One other patient was revised for loosening which developed between 'Virtual Clinic' appointments. Surgeon feedback indicated the inclusion of a 'comment' section on the questionnaire as particularly useful.
We describe our adoption of a 'Virtual Clinic' for joint replacement follow up. We recommend this system as a practical method of following up patients.
我们使用“虚拟诊所”对髋关节和膝关节置换患者进行随访。本研究的目的是调查使用该系统时患者的依从性、疼痛和功能、翻修率以及外科医生的经验。
2000年起进行的所有髋关节和膝关节置换均适用于“虚拟诊所”评估。在2014年7月至2016年12月期间，所有应进行随访的患者（术后1年、5年和7年，或此后每两年）均收到一份牛津髋关节或膝关节评分表以及一张X光片检查申请。一名外科医生对问卷和X光片进行评估，并决定是否需要进行面对面评估。我们将依从性计算为完成“虚拟诊所”评估的合格患者的百分比。我们对所有诊所参与者的病历进行回顾性分析，以分析牛津评分、预约后的处理情况以及翻修率。我们在2017年12月对所有诊所参与者进行了复查，以确定是否有进一步的翻修情况。通过电子邮件调查评估外科医生的反馈。
共有2076名患者应进行随访。1405名患者可以联系到，其中710名完成了整个流程。我们计算出依从率为36%。外科医生决定对162名（23%）平均牛津评分为24.2的患者进行面对面评估。这确定了13名需要翻修的患者。另有一名患者因在“虚拟诊所”预约期间出现松动而进行了翻修。外科医生的反馈表明，问卷中包含“评论”部分特别有用。
我们描述了我们采用“虚拟诊所”进行关节置换随访的情况。我们推荐该系统作为随访患者的一种实用方法。
