Platt Nicholas A, Bolland Benjamin
University of Bristol, Bristol, UK.
Musgrove Park Hospital, Taunton, UK.
Eur J Orthop Surg Traumatol. 2025 Aug 26;35(1):361. doi: 10.1007/s00590-025-04479-y.
Virtual follow-up programmes offer an alternative to traditional in-person appointments, aiming to reduce patient burden and optimise healthcare resources. Following a successful pilot in 2020, the virtual arthroplasty follow-up (VARF) pathway was formally implemented to monitor total hip replacement (THR) patients. This study evaluates the clinical outcomes, patient satisfaction, economic impact, and environmental benefits of VARF in a large cohort.
A retrospective analysis was performed on a prospectively maintained database of 319 patients who underwent primary THR between January 2022 and July 2023. Follow-up was conducted using Oxford Hip Scores (OHS) and radiographs. Patient satisfaction was assessed via telephone survey in a representative sample of 35 patients. Estimated carbon dioxide emissions related to clinic visits were calculated based on previously published data.
A total of 92.2% (n = 294) of patients were successfully managed through VARF. Patient satisfaction was high, with 86% of respondents reporting they were 'satisfied' or 'very satisfied', and 69% perceiving time and cost-savings. Financial analysis demonstrated an average saving of £11.78 per patient in fuel and parking costs. A theoretical cost reduction of £48,978.91 was identified for the Trust, primarily due to operational efficiencies and the release of clinic time. While not a direct monetary saving, this freed capacity allowed reallocation for other clinical purposes, enhancing overall service efficiency. Environmentally, the programme prevented an estimated 19,691 kg of CO equivalent emissions by reducing in-person visits.
VARF is a safe, effective, and patient-centred approach for THR follow-up, achieving high satisfaction rates while delivering significant cost and environmental benefits. This model demonstrates strong potential for wider adoption in arthroplasty post-operative care.
虚拟随访计划为传统的面对面预约提供了一种替代方案，旨在减轻患者负担并优化医疗资源。在2020年成功试点之后，虚拟关节置换随访（VARF）途径正式实施，以监测全髋关节置换（THR）患者。本研究评估了大型队列中VARF的临床结果、患者满意度、经济影响和环境效益。
对2022年1月至2023年7月期间接受初次THR的319例患者的前瞻性维护数据库进行回顾性分析。使用牛津髋关节评分（OHS）和X光片进行随访。通过对35例患者的代表性样本进行电话调查来评估患者满意度。根据先前发表的数据计算与门诊就诊相关的估计二氧化碳排放量。
共有92.2%（n = 294）的患者通过VARF得到成功管理。患者满意度较高，86%的受访者表示他们“满意”或“非常满意”，69%的人认为节省了时间和成本。财务分析表明，每位患者在燃料和停车成本方面平均节省11.78英镑。信托机构确定理论成本降低了48,978.91英镑，主要是由于运营效率提高和门诊时间的释放。虽然这不是直接的货币节省，但这种腾出的能力允许重新分配用于其他临床目的，提高了整体服务效率。在环境方面，该计划通过减少面对面就诊估计避免了19,691千克二氧化碳当量的排放。
VARF是一种安全、有效且以患者为中心的THR随访方法，在实现高满意度的同时带来了显著的成本和环境效益。该模式在关节置换术后护理中具有广泛采用的强大潜力。
