Remote Follow-up of Shoulder Arthroplasty Patients During COVID-19 Pandemic - Is This the way Forward?

Abstract

Background The COVID-19 Pandemic has affected the way health care systems function across the globe. Apart from eliminating the risk of being in a vulnerable environment during the pandemic such as a hospital setting, virtual arthroplasty follow-up reduces the demand on funding and resources on the National Health Services (NHS). Methods We retrospectively reviewed our shoulder arthroplasty patients (55) operated between October 2018 to November 2020 at both our hospital sites. For remote follow-up, patients were contacted on a scheduled appointment date via telephone by an orthopaedic surgeon to enquire about their wound, pain and function. Patients were questioned as per questionnaire from the Oxford Shoulder Score (OSS) and American Shoulder and Elbow Surgeons (ASES) Standardised Assessment form. Results 50 patients were included in the final data set after excluding those who had died (5 patients). All patients had had final x-rays with full Covid-19 precautions at the time of final follow-up. No patient had wound problems except one who had concerns of wound appearance. There were no cases of notching, impingement, deep infection, dislocation or nerve injury. Of the 50 patients, 40 (80%) patients were satisfied to have a remote follow-up. 36 (72%) patients said they wouldn't mind a remote follow-up appointment. Conclusion Remote follow-up via audio consultation may be an effective alternative to in person visits after shoulder arthroplasty. Patients in this series demonstrated a high level of satisfaction with virtual visits and post-operative complications were effectively identified.

Scoping review: Evidence for long-term follow-up and monitoring in shoulder and elbow arthroplasty

“…Mansukhani et al 24 report similar satisfaction with telephone follow-up by a consultant surgeon in their retrospective review. 55 shoulder arthroplasty patients were contacted on a scheduled appointment date ‘to enquire about their wound, pain and function.’ Patients were questioned as per the questionnaire from the Oxford Shoulder Score (OSS) and American Shoulder and Elbow Score (ASES).…”

“…Mansukhani et al 24 report similar satisfaction with telephone follow-up by a consultant surgeon in their retrospective review. 55 shoulder arthroplasty patients were contacted on a scheduled appointment date 'to enquire about their wound, pain and function.'…”

Outcomes of reverse total shoulder arthroplasty were not adversely affected by the COVID-19 pandemic

“…These studies found an overall decreased length of postoperative hospital stay, increased discharged-home rate, no significant change in 30-day readmission rates, and an increased use of telemedicine for follow-ups. 1 , 16 ,20,22 The impact of COVID-19 on long-term post-surgical rehabilitation and physical therapy has not been well studied. Evaluating the effect of COVID-19 on long-term postoperative management and rehabilitation of RTSA can provide insight into future management.…”