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初次关节置换术后一年常规随访的负担和效用。

The burden and utility of routine follow-up at one year after primary arthroplasty.

机构信息

Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.

出版信息

Bone Joint J. 2020 Jul;102-B(7_Supple_B):85-89. doi: 10.1302/0301-620X.102B7.BJJ-2019-1632.R1.

Abstract

AIMS

Routine surveillance of primary hip and knee arthroplasties has traditionally been performed with office follow-up visits at one year postoperatively. The value of these visits is unclear. The present study aims to determine the utility and burden of routine clinical follow-up at one year after primary arthroplasty to patients and providers.

METHODS

All patients (473) who underwent primary total hip (280), hip resurfacing (eight), total knee (179), and unicompartmental knee arthroplasty (six) over a nine-month period at a single institution were identified from an institutional registry. Patients were prompted to attend their routine one-year postoperative visit by a single telephone reminder. Patients and surgeons were given questionnaires at the one-year postoperative visit, defined as a clinical encounter occurring at nine to 15 months from the date of surgery, regarding value of the visit.

RESULTS

Compliance with routine follow-up at one year was 35%. The response rate was over 80% for all questions in the patient and clinician surveys. Overall, 75% of the visits were for routine surveillance. Patients reported high satisfaction with their visits despite the general time for attendance, including travel, being over four hours. Surgeons found the visits more worthwhile when issues were identified or problems were addressed.

CONCLUSION

Patient compliance with follow-up at one year postoperatively after primary hip and knee is low. Routine visits of asymptomatic patients deliver little practical value and represent a large time and cost burden for patients and surgeons. Remote strategies should be considered for routine postoperative surveillance primary hip and knee arthroplasties beyond the acute postoperative period. Cite this article: 2020;102-B(7 Supple B):85-89.

摘要

目的

传统上,对初次髋关节和膝关节置换术进行常规监测是通过术后一年的门诊随访来完成的。这些就诊的价值尚不清楚。本研究旨在确定初次关节置换术后一年常规临床随访对患者和医生的实用性和负担。

方法

从一家机构的机构注册处确定了在九个月内接受初次全髋关节置换术(280 例)、髋关节表面置换术(8 例)、全膝关节置换术(179 例)和单髁膝关节置换术(6 例)的所有患者(473 例)。通过单一电话提醒提示患者参加其常规的术后一年随访。在术后一年时,患者和外科医生会收到一份调查问卷,将手术日期后的 9 至 15 个月定义为临床随访,询问他们对就诊的价值的看法。

结果

在一年时进行常规随访的依从率为 35%。患者和临床医生调查问卷中的所有问题的回复率均超过 80%。总体而言,75%的就诊是为了常规监测。尽管就诊的总时间(包括旅行)超过四小时,但患者仍对就诊表示高度满意。当发现问题或解决问题时,外科医生认为就诊更有价值。

结论

初次髋关节和膝关节置换术后一年的患者对随访的依从性较低。对无症状患者进行常规随访几乎没有实际价值,并且给患者和外科医生带来了巨大的时间和成本负担。应考虑在初次髋关节和膝关节置换术后的急性术后阶段之后,采用远程策略进行常规术后监测。

引用本文

2020;102-B(7 增刊 B):85-89.

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