Patients Are Generally Satisfied with Telemedicine Visits After Arthroscopic Meniscal Surgery
After arthroscopic surgery on the meniscus of the knee, patients using telemedicine for postoperative follow-up are just as satisfied with their care as those making in-person visits, according to research from NYU Langone Health.
The study, published online ahead of print by The Journal of Bone & Joint Surgery, included 122 patients who underwent either arthroscopic meniscectomy or isolated arthroscopic meniscal repair. Patients were randomly assigned to receive office-based or telemedicine follow-up, scheduled for 5 to 14 days postoperatively.
During both types of follow-up visits, the surgeon talked with the patient about the surgical findings, asked about the patient’s pain and postoperative recovery, and performed a physical examination that included range-of-motion testing. Surgeons could not feel or touch the knee during telemedicine follow-up visits, of course, but they were still able to perform a visual assessment of wound healing, drainage, and swelling.
Telemedicine follow-up visits were done via the patient’s home computer or mobile device using a telemedicine program that was compliant with privacy rules.
In patient surveys, overall satisfaction ratings were nearly identical between groups. Average patient satisfaction scores (on a 0-to-10 scale) were 9.77 with office-based follow-up and 9.79 for telemedicine follow-up. In both groups, only about 20% of patients said they would have preferred the other type of visit. Pain scores also showed similar improvement between groups: from about 5 (out of 10) on the day of the surgery to 3 at the follow-up visit.
Both groups had low complication rates. Two patients in each group had pain and swelling, raising concern about a possible venous thromboembolism (VTE). All 4 patients were sent for same-day Doppler ultrasound scans, which found no evidence of VTE. “All potential complications were identified, and there were no subsequent or missed complications identified on subsequent chart review,” the researchers said in their paper.
Telemedicine is a promising approach to delivering care to patients with a variety of conditions. During the COVID-19 pandemic, the use of telemedicine in routine medical care has greatly accelerated; the researchers had begun their study well before the start of the pandemic.
Although studies have reported a wide range of benefits from telemedicine visits, there are mixed data regarding satisfaction with telemedicine visits among patients undergoing common orthopaedic procedures. The new study is the first to directly compare telemedicine with standard office-based follow-up after orthopaedic surgery.
“Telemedicine may be a reasonable alternative to office-based follow-up after knee arthroscopy,” the researchers concluded. “[Our] study only evaluated the first postoperative visit, but future studies may benefit from expanding the use of telemedicine to longer-term follow-ups or to additional surgical procedures.”
Herrero CP, Bloom DA, Lin CC, et al. Patient satisfaction is equivalent using telemedicine versus office-based follow-up after arthroscopic meniscal surgery: a prospective, randomized controlled trial. J Bone Joint Surg Am. 2021 Mar 15. doi: 10.2106/JBJS.20.01413. Online ahead of print.