Hip and knee replacements: Should we follow them up? A survey of orthopaedic health professionals.

Abstract

The aim of this study was to collect evidence on the current view of orthopaedic health professionals on follow-up services after hip or knee replacement. It consisted of a short survey that was distributed, following ethical approval, at the British Association for Surgery of the Knee (BASK) and the British Hip Society 2018 annual meetings with the agreement of their executive committees. One hundred and seventy-two delegates completed the surveys with a high response rate. The majority of respondents were orthopaedic consultants (mean years since qualification = 18), with 13% of the participants from an allied health professional or research background. Results showed that 87% (hips) and 78% (knees) of healthcare professionals (HCPs) supported long-term follow-up by the orthopaedic community with 33% stating that changes are needed in the intervals for review and age limits as recommended in the current NICE guidelines. Freehand comments noted concerns about skilled assessment and cost; some included suggestions for alternative models of care. Seventy-four percent of HCPs were in favour of using arthroplasty practitioner services with the majority preferring a virtual arthroplasty practitioner service. Forty-six percent of HCPs were aware of their local National Health Service plans for sustainability and transformation (STP). Of these, 61% reported that their responses were not consistent with their local STP. In conclusion, there continues to be widespread support for arthroplasty follow-up services. However, with the current pressure on healthcare resources, a re-evaluation of recommended follow-up services and their method of delivery is required.