Providing a standardised approach to virtual clinical follow up of total joint replacement


Aims: The overall aim of this study is to provide a standardised approach and assessment for virtual clinic follow-up of total joint replacement and the management of patients subsequently identified as ‘at risk’


Delphi approach and prospective study 

Background: Total joint replacement (TJR) is rapidly increasing placing consequent massive burden for follow-up on already over-stretched orthopaedic services. Patients have indicated they want to know their follow-up is appropriate and expert-led. We have demonstrated that a virtual clinic model is feasible and have developed a preliminary questionnaire for patient-reported measures; this needs further development, validation and testing in a real-world setting before it can be widely implemented as part of the standard approach for virtual clinic follow-up of TJR. We also do not have standards for radiology reporting of TJR follow-up X-rays and these need to be developed. For those patients identified through questionnaire and/or X-ray as potentially ‘at risk’ of requiring revision of their TJR (e.g. presenting with symptoms of severe pain or marked structural changes on X-ray), we are lacking in clarity and guidance on how to manage these patients.


Professor Philip Conaghan, Leeds Musculoskeletal Biomedical Research Centre, University of Leeds
Mr Martin Stone, Leeds Teaching Hospital NHS Trust and University of Leeds
Professor Gretl McHugh, School of Healthcare, University of Leeds
Dr Sarah Kingsbury, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds
Dr Elizabeth Hensor, Leeds Musculoskeletal Biomedical Research Centre, University of Leeds
Dr Philip O’Connor, Leeds Teaching Hospital NHS Trust
Dr Andrew Grainger, Leeds Teaching Hospitals NHS Trust
Mrs Christine Thomas, Patient Representative.

Funding body: Arthritis Research UK; amount TBC

Contact: Professor Gretl McHugh