Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin, Ireland.
School of Medicine, Trinity College Dublin, Dublin, Ireland; National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery.
Surgeon. 2022 Jun;20(3):177-186. doi: 10.1016/j.surge.2021.02.008. Epub 2021 Mar 21.
The Orthopaedic Trauma Association has recommended limitation of in-person encounters to absolute necessity. One method of ensuring standard patient care within these guidelines is through the implementation of telemedicine.
To evaluate the efficacy of telemedicine for elective orthopaedic patients in the recovery and/or rehabilitation period.
A systematic review and meta-analysis of articles in Medline/PubMed and The Cochrane Library databases was performed according to the PRISMA guidelines for prospective randomised controlled trials to compare clinical and symptomatic measures for elective patients managed routinely with remote care compared to those managed with standard in-clinic management. To be included for meta-analysis, parameters must be evaluated in ≥3 studies.
Eleven studies were included in the meta-analyses. Both telemedicine and control cohorts were comparable for patient satisfaction (RR, 0.98; 95% CI, 0.90-1.07; I = 0%; p = 0.52) and patient retention analysis (RR, 1.25; 95% CI, 0.51-3.06; p = 0.54; I = 0%). Similarly, there was no statistical difference appreciated between cohorts for overall Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (p = 0.30), Timed Up and Go Test (p = 0.40), and Stair Test (p = 0.18). Significant difference did exist for visual analogue scale (VAS) scores (p = 0.02) in favour of in-clinic management.
Telemedicine will serve an integral aspect of healthcare delivery throughout the current COVID-19 pandemic and beyond in an effort to deliver safe, efficient and time-sensitive care to the orthopaedic patient population. The results of our meta-analyses indicate that virtual consultations are as effective as traditional in-person consultations for the care of elective orthopaedic patients in the recovery and rehabilitation period. However, further studies are needed to evaluate for initial consultations and certain sub-specialties of orthopaedics.
矫形创伤协会建议将面对面的接触限制在绝对必要的范围内。在这些指导方针内确保标准患者护理的一种方法是通过实施远程医疗。
评估远程医疗在恢复和/或康复期的择期矫形患者中的疗效。
根据 PRISMA 指南对 Medline/PubMed 和 Cochrane 图书馆数据库中的文章进行系统评价和荟萃分析，以比较常规远程护理管理的择期患者与标准门诊管理的患者的临床和症状测量值。要进行荟萃分析，参数必须在≥3 项研究中进行评估。
11 项研究被纳入荟萃分析。远程医疗和对照组在患者满意度（RR，0.98；95%CI，0.90-1.07；I = 0%；p = 0.52）和患者保留分析（RR，1.25；95%CI，0.51-3.06；p = 0.54；I = 0%）方面具有可比性。同样，两组之间在总体西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）评分（p = 0.30）、起立-行走测试（p = 0.40）和楼梯测试（p = 0.18）方面没有统计学差异。在视觉模拟量表（VAS）评分方面存在显著差异（p = 0.02），有利于门诊管理。
远程医疗将在当前 COVID-19 大流行期间及以后成为医疗保健服务的一个组成部分，以向矫形患者群体提供安全、高效和及时的护理。我们的荟萃分析结果表明，虚拟咨询与传统的面对面咨询一样，可有效治疗恢复和康复期的择期矫形患者。然而，还需要进一步的研究来评估初始咨询和某些矫形亚专业。
