An audit of the out-patient follow-up of hip and knee replacements

Bhatia, Monisha C; Obadare, Z

doi:10.1308/003588403321001408

Cited by 19 publications

(13 citation statements)

References 2 publications

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“…The benefits of regular followup include regular joint evaluation and possible avoidance of more costly revision in the event of joint failure and collection of current and complete data allowing more comprehensive evaluation of implants and surgical techniques [8][9][10]14]. The appropriate interval for regular followup, whether appropriate followup requires a visit to the surgeon or followup by other means, and the costs associated to maintain followup are controversial and beyond the scope of this study [2,3,7,13,14,16].…”

Section: Resultsmentioning

confidence: 99%

Lessons Learned From Managing a Prospective, Private Practice Joint Replacement Registry: A 25-year Experience

Carothers

White

Tripuraneni

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background In 1984, we developed a private practice joint replacement registry (JRR) to prospectively follow patients undergoing THA and TKA to assess clinical and radiographic outcomes, complications, and implant survival. Little has been reported in the literature regarding management of this type of database, and it is unclear whether and how the information can be useful for addressing longer-term questions. Questions/purposes We answered the following questions: (1) What is the rate of followup for THA and TKA in our JRR? (2) What factors affect followup? (3) How successful is this JRR model in capturing data and what areas of improvement are identified? And (4) what costs are associated with maintaining this JRR? Methods We collected clinical data on all 12,047 patients having primary THA and TKA since 1984. Clinical and radiographic data were collected at routine followup intervals and entered into a prospective database. We searched this database to assess the rate of successful followup and data collection and to compare the effect of patient variables on followup. Costs related to database management were evaluated. Results Followup was poor at every time interval after surgery, with a tendency for worsening over time. Patients with a complication and those younger than 70 years tended to followup with greater frequency. There were difficulties with data capture and substantial expenses related to managing the database. Conclusions Our findings highlight the difficulties in managing a JRR. Followup is poor and data collection is often incomplete. Newer technologies that allow easier tracking of patients and facilitate data capture may streamline this process and control costs.

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Section: Resultsmentioning

confidence: 99%

Lessons Learned From Managing a Prospective, Private Practice Joint Replacement Registry: A 25-year Experience

Carothers

White

Tripuraneni

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Regular follow-up visits, including radiographs, enable the surgeon to assess the result of a surgery and can rule out the possible need for revision, amongst other complications [9] . The delayed diagnosis of potential problems such as osteolysis, subsidence, component loosening, and infection can result in the need for a complex and costly revision surgeries [10,11] , which often have less certain and worse outcomes than primary joint replacement [12] . As addressed, follow-up visits are also important for patient-reported outcomes based studies of TJA; however, despite recommendations from surgeons, not all patients that undergo TJA return to the office for routine examination.…”

Section: Introductionmentioning

confidence: 99%

How are those “lost to follow-up” patients really doing? A compliance comparison in arthroplasty patients

Choi¹,

Geller²,

Patrick³

et al. 2015

WJO

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AIM:To determine whether there is a functional difference between patients who actively follow-up in the office (OFU) and those who are non-compliant with office follow-up visits (NFU). METHODS:We reviewed a consecutive group of 588 patients, who had undergone total joint arthroplasty (TJA), for compliance and functional outcomes at one to two years post-operatively. All patients were given verbal instructions by the primary surgeon to return at one year for routine follow-up visits. Patients that were compliant with the instructions at one year were placed in the OFU cohort, while those who were non-compliant were placed in the NFU cohort. Survey mailings and telephone interviews were utilized to obtain complete follow-up for the cohort. A χ 2 test and an unpaired t test were used for comparison of baseline characteristics. Analysis of covariance was used to compare the mean clinical outcomes after controlling for confounding variables. RESULTS:Complete follow-up data was collected on 554 of the 588 total patients (93%), with 75.5% of patients assigned to the OFU cohort and 24.5% assigned to the NFU cohort. We found significant differences between the cohorts with the OFU group having a higher mean age (P = 0.026) and a greater proportion of females (P = 0.041). No significant differences were found in either the SF12 or WOMAC scores at baseline or at 12 mo postoperative. CONCLUSION:Patients who are compliant to routine follow-up visits at one to two years post-operation do not experience better patient reported outcomes than those that are non-compliant. Additionally, after TJA, older women are more likely to be compliant in following surgeon instructions with regard to follow-up office care. Prospective Studyare non-compliant with the surgeon requested followup protocol. This study aims to determine if there is a functional difference between patients who actively follow-up in office and those who are non-compliant with the visit protocol. Based on our results, patient compliance to routine follow-up visits at 12-24 mo post-operation does not lead to better patient-reported functional outcomes than those who are non-compliant. Additionally, older women are more likely to be compliant in adhering to surgeon post-operative followup instructions.

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“…The longevity of total joint arthroplasty can be limited by problems such as wear-debris-induced osteolysis and aseptic loosening [4][5][6][7] . Unfortunately, delayed diagnosis of these problems can result in the need for complex and costly revision surgery 8,9 . Thus, periodic postoperative clinical and radiographic analysis to provide early detection of bearing surface wear, osteolysis, and implant loosening seems prudent.…”

mentioning

confidence: 99%