Staying in the Loop after Knee Replacement SurgeryPatients who get a total knee replacement (TKR) are told to come back to the doctor's office on a regular basis for check-ups. If they don't return, does that mean the operation failed and they are seeing someone else now? Doctors at Brigham and Women's Hospital in Boston used the internet to find patients who didn't come back and see what happened to them.
There were 161 patients with a total of 200 TKR surgeries. Thirty of those patients had not been in contact with the surgeon for at least six months. Seventeen patients were contacted using information from their charts. The 13 remaining "lost" patients were found using search engines on the internet.
Each patient had a TKR for at least five years. All patients were asked about their knee implants. Having any problems? Seeing another doctor? Why didn't you come back? The researchers report that only three patients were seeing another doctor somewhere else, for convenience. The patients who weren't followed had the same outcomes as those who did have follow-up. No one had more knee surgery after the TKR.
There were many reasons why patients didn't go to their follow-up appointments. The two most common ones were death (unrelated to the TKR) and not knowing they needed to see their doctors. A secondary reason given by many patients was that they weren't having any problems with their knees. Most of the patients who didn't have follow-up care were older at the time of the surgery.
The authors say that finding problems early after a TKR can prevent further surgery. Everyone should be told how important follow-up appointments are after TKR. Patients should be seen by their doctors every one to two years. This study shows that doctors can find patients who don't come back by using the internet. It's free, and it doesn't take much time to locate lost patients.
Paul J. King, MD, et al. The Fate of Patients Not Returning for Follow-Up Five Years After Total Knee Arthroplasty. In The Journal of Bone and Joint Surgery. May 2004. Vol. 86-A. No. 5. Pp. 897-901.
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