Can virtual consultations replace physical visits before knee arthroplasty? : a retrospective cohort study.

Abstract

With increasing demand for knee arthroplasties, innovative approaches like virtual consultations are gaining traction. This study assesses the feasibility of using virtual consultation as arthroplasty for in-person consultations in patients undergoing total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA). This single-centre cohort study evaluated patients receiving virtual consultations as their primary contact and followed patients scheduled for primary TKA or medial UKA after virtual consultations as their sole preoperative contact between 1 January 2023 and 30 June 2023. Visitation criteria for virtual consultation were severe radiologically confirmed osteoarthritis (Kellgren-Lawrence grade ≥ 3 and American Society of Anesthesiologists grade ≤ 2). Outcomes measured included the proportion of patients scheduled for surgery directly after virtual consultation and those requiring additional in-person consultations. Secondary outcomes included the completion of scheduled surgeries, conversion rates from UKA to TKA, and the proportion of patients successfully completing outpatient surgery. A total of 303 patients received virtual consultations, and 97 (32%) were directly scheduled for surgery. Overall, 123 patients (41%) required in-person consultations, while 83 patients (27%) were managed directly after virtual consultation without surgery. Among the directly scheduled surgeries, 82 (85%) proceeded without changes to the planned course. No perioperative conversions from UKA to TKA occurred. In total, 57 patients (70%) were eligible for outpatient surgery, and 41 of these (72%) successfully completed the course and were discharged on the day of surgery. This study found it feasible to use virtual consultations as replacement for in-person consultations prior to knee arthroplasty surgery for a selected group of patients. Future research should explore patient safety and patient-reported outcomes to validate these findings.