Can virtual consultations replace physical visits before knee arthroplasty?

Listen to Brian and Lisa discuss the paper 'Can virtual consultations replace physical visits before knee arthroplasty?' published in the February 2026 issue of Bone & Joint Open.

Click here to read the paper.

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Transcript

[00:00:00] Welcome back to another episode of AI Talks with Bone & Joint from the publishers of Bone & Joint Open. Today we're discussing the paper 'Can virtual consultations replace physical visits before knee arthroplasty?' published in February 2026 by RT Paulsen and colleagues. I'm Brian and I'm joined by my co-host Lisa.

Hello Brian and good day to all our listeners. This is quite an intriguing topic as it explores the future of orthopaedics with virtual consultations potentially transforming preoperative care. Let's dive in!

The impetus for this research is the increasing demand for knee arthroplasties. Combined with demographic shifts and mounting pressure on healthcare budgets, there's a pressing need to innovate and streamline preoperative procedures. Virtual consultations offer a promising solution to this challenge.

The study focused on patients undergoing total knee or unicompartmental knee arthroplasty. The aim was to determine if virtual consultations could substitute the [00:01:00] usual in-person visits before these surgeries.

This single-centre cohort study was conducted at Lillebaelt Hospital in Denmark. The researchers reviewed patients who had virtual consultations as their main preoperative interaction between January and June 2023. Eligible patients had severe radiologically confirmed osteoarthritis and were otherwise healthy with a score of two or less on the American Society of Anesthesiologist's scale.

Referrals were screened by experienced knee arthroplasty surgeons and eligible patients received digital invitations for video consultations. During these calls, the surgeons assess symptoms, medical history, and even conducted visual knee inspections via video. They reviewed radiographs and then decided if the patient required total or unicompartmental knee arthroplasty.

Remarkably out of 303 patients who underwent virtual consultations, 97 were scheduled for surgery, [00:02:00] amounting to about 32%. A further 123 patients needed in-person consultations, but an intriguing 27% were managed entirely through virtual consultations without the need for surgery. And from those 97 surgeries, 85% proceeded without any modifications and none of the unicompartmental knee arthroplasty patients had to be converted to total knee arthroplasty on the day of surgery.

This illustrates the reliability of virtual consultations in preoperative planning. Additionally, 70% of patients scheduled for outpatient surgery were successfully discharged on the day of their procedure, indicating no compromise in the surgical process, due to the virtual consultations. The study also highlighted the benefits of virtual consultations in terms of time management and environmental impact.

This approach not only saves patients time, but also reduces carbon dioxide emissions, making it a greener alternative compared to [00:03:00] traditional methods involving physical travel and waiting periods. And we mustn't overlook the economic advantages, virtual consultations can be more cost-effective, as previous research has indicated.

They offer flexibility and convenience, allowing healthcare to integrate more seamlessly into busy schedules without necessitating physical travel. Quite so, but the study also mentioned some challenges, didn't it? For example, difficulties in assessing certain physical cues and performing specialized tests in a virtual environment.

This may occasionally lead to diagnostic inaccuracies. There were minor connectivity issues too, though these were minimal in this study. True, despite the high success rate issues such as technical difficulties or the inability to evaluate things like ligament stability virtually, do present limitations. However, these can be mitigated by the surgeon's expertise and the nature of the condition and symptoms.

So, Brian, what are the main takeaways from this study for our [00:04:00] listeners? The main takeaway is that virtual consultations can effectively replace in-person consultations for a specific subset of knee arthroplasty patients, potentially saving time, reducing costs, and lessening environmental impact.

However, it's crucial to note that this is more suitable for patients with clear surgical indications and advanced radiological evidence of osteoarthritis. From a broader perspective, incorporating virtual consultations into orthopaedics could enhance healthcare efficiency, especially when combined with outpatient surgeries.

While there are some technological and diagnostic challenges, a balanced approach with experienced professionals can make this a viable option. Precisely, future research should continue to explore patient-reported outcomes and the broader cost effectiveness of this approach to further cement its place in diverse healthcare settings.

Well, that brings us to the end of today's episode. Many thanks to all of you for [00:05:00] tuning in.