Prospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2015; 6(1): 150-155
Published online Jan 18, 2015. doi: 10.5312/wjo.v6.i1.150
How are those “lost to follow-up” patients really doing? A compliance comparison in arthroplasty patients
Jung Keun Choi, Jeffrey A Geller, David A Patrick Jr, Wenbao Wang, William Macaulay
Jung Keun Choi, Jeffrey A Geller, David A Patrick Jr, Wenbao Wang, William Macaulay, Center for Hip and Knee Replacement, Department of Orthopaedic Surgery, NewYork-Presbyterian Hospital at Columbia University Medical Center, New York, NY 10032, United States
Author contributions: All authors meet ICJME authorship guidelines; Choi JK, Geller JA and Macaulay W designed the research; Choi JK, Geller JA and Wang W performed the research; Choi JK, Wang W and Patrick Jr DA analyzed data; Choi JK, Geller JA, Patrick Jr DA, Wang W and Macaulay W wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: William Macaulay, MD, Nas Eftekhar Professor of Clinical Orthopaedic Surgery, Center for Hip and Knee Replacement, Department of Orthopaedic Surgery, NewYork-Presbyterian Hospital at Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, United States. wm143@columbia.edu
Telephone: +1-212-3058193 Fax: +1-212-3054024
Received: March 28, 2014
Peer-review started: March 31, 2014
First decision: May 14, 2014
Revised: May 30, 2014
Accepted: August 27, 2014
Article in press: August 29, 2014
Published online: January 18, 2015
Processing time: 298 Days and 9.9 Hours
Abstract

AIM: To determine whether there is a functional difference between patients who actively follow-up in the office (OFU) and those who are non-compliant with office follow-up visits (NFU).

METHODS: We reviewed a consecutive group of 588 patients, who had undergone total joint arthroplasty (TJA), for compliance and functional outcomes at one to two years post-operatively. All patients were given verbal instructions by the primary surgeon to return at one year for routine follow-up visits. Patients that were compliant with the instructions at one year were placed in the OFU cohort, while those who were non-compliant were placed in the NFU cohort. Survey mailings and telephone interviews were utilized to obtain complete follow-up for the cohort. A χ2 test and an unpaired t test were used for comparison of baseline characteristics. Analysis of covariance was used to compare the mean clinical outcomes after controlling for confounding variables.

RESULTS: Complete follow-up data was collected on 554 of the 588 total patients (93%), with 75.5% of patients assigned to the OFU cohort and 24.5% assigned to the NFU cohort. We found significant differences between the cohorts with the OFU group having a higher mean age (P = 0.026) and a greater proportion of females (P = 0.041). No significant differences were found in either the SF12 or WOMAC scores at baseline or at 12 mo postoperative.

CONCLUSION: Patients who are compliant to routine follow-up visits at one to two years post-operation do not experience better patient reported outcomes than those that are non-compliant. Additionally, after TJA, older women are more likely to be compliant in following surgeon instructions with regard to follow-up office care.

Keywords: Total joint arthroplasty; Revision joint arthroplasty; Functional outcomes; Patient compliance; Patient follow-up

Core tip: Following total joint arthroplasty, often patients are non-compliant with the surgeon requested follow-up protocol. This study aims to determine if there is a functional difference between patients who actively follow-up in office and those who are non-compliant with the visit protocol. Based on our results, patient compliance to routine follow-up visits at 12-24 mo post-operation does not lead to better patient-reported functional outcomes than those who are non-compliant. Additionally, older women are more likely to be compliant in adhering to surgeon post-operative follow-up instructions.