Virtual arthroplasty follow-up (VARF) in total hip replacement: a safe, effective, and sustainable model for post-operative care.

Abstract

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 CO₂ 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.