Digital Follow-Up After Total Knee Arthroplasty: An Interview Study Among Orthopaedic Surgeons.

Background

Traditionally, patients who undergo total knee arthroplasty (TKA) are scheduled for an in-person routine follow-up (RFU) regimen. Increasing pressure on orthopaedic services and growing acceptance of digital health technologies urge clinics to adopt more efficient RFU strategies. However, limited insight exists into how RFU after TKA is organised in clinical practice and under which conditions digital follow-up is acceptable to orthopaedic surgeons. This study explored current RFU practices after TKA and examined surgeons' perspectives on digital follow-up.

Methods

A qualitative study using semi-structured interviews was conducted with 21 orthopaedic surgeons from different healthcare institutions. Interviews were conducted digitally, transcribed verbatim, and analysed using qualitative analysis software. Two researchers independently coded the transcripts, after which the codes were compared, refined, and grouped into overarching themes.

Results

Four main themes emerged. (1) RFU after TKA was highly fragmented across institutions, with variation in timing, contact modality, responsible healthcare provider, and use of radiographic assessment. (2) Follow-up visits were primarily perceived as a means to confirm uncomplicated recovery and detect complications early. (3) Digital follow-up was viewed not as a replacement for in-person visits but as an additional triage strategy to support decisions on physical consultation. (4) Acceptance of digital follow-up depended on clear patient selection, predefined clinical recovery indicators, and preservation of professional and patient autonomy.

Conclusion

RFU after TKA is poorly standardized and institution dependent. Digital follow-up is considered acceptable mainly as a triage mechanism if patient safety, professional autonomy, and the surgeon-patient relationship are maintained.

Keywords

digital health, digital triage, orthopaedics, routine follow‐up, total knee arthroplasty

Conflict of interest statement

Casper Craamer and Thomas Timmers are employed in the research and development department of Interactive Studios. Interactive Studios is a company that develops a smartphone app that can be used for telemonitoring. The other coauthors declare that the research was conducted in the absence of any other commercial or financial relationships that could be construed as a potential conflict of interest. Moreover, all authors have completed the ICMJE uniform disclosure form and declare the following: no support from any organization for the submitted work, no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years, and no other relationships or activities that could appear to have influenced the submitted work.