Automated Text Messaging After Hip Arthroscopy: A randomized-controlled trial of "Post-Op Buddy"

Arthroscopy. 2021 Oct 13:S0749-8063(21)00888-4. doi: 10.1016/j.arthro.2021.09.030. Online ahead of print.

ABSTRACT

PURPOSE: To assess an automated text messaging system for patients after hip arthroscopy and its impact at 90 days on the Hip Disability Osteoarthritis Outcome Score (HOOS-PS, HOOS-PAIN), compliance with rehabilitation guidelines and patient satisfaction.

METHODS: One hundred twenty-one participants (average age 29±8.7 years, 52% female) undergoing hip arthroscopy at two academic institutions were prospectively enrolled and randomized to receive (1) standard perioperative communication or (2) additional automated mobile phone text messages. Inclusion criteria included ability to communicate in written English and access to a mobile phone with text messaging capability. Patients undergoing revision surgery or simultaneous femoral or acetabular osteotomy were excluded. HOOS-PS and HOOS-PAIN were collected pre-operatively, and after surgery an automated mobile phone robot sent participants in the therapeutic arm intermittent text messages for 90 days. At 90 days all participants again completed HOOS-PS, HOOS-PAIN, and additional survey questions on satisfaction with their experience (10-point scale), communication from the surgical team (10-point scale) and adherence to physical therapy exercises, weightbearing guidelines, and brace use, The primary outcome assessed was a statistically significant change in HOOS-PS and HOOS-PAIN; secondary outcomes included change in satisfaction, communication, and adherence to physical therapy exercises, weightbearing guidelines, or brace use. Wilcoxon rank sum was used to compare HOOS-PS and HOOS-PAIN scores at 0 and 90 days. Demographic characteristics and survey variables were compared using Students t-test for continuous variables and chi square or Fisher exact test for categorical variables as appropriate.

RESULTS: There were statistically significant and clinically relevant improvements in HOOS-PS and HOOS-PAIN in both groups (p<0.05). Subjective feedback was strongly positive, with 96% of text message participants reporting they would choose automated messages if it was offered to them again in the future.

CONCLUSION: Ninety days of automated text messaging after hip arthroscopy failed to show a significant difference in HOOS-PS (p=0.09), HOOS-PAIN (p=0.13), patient reported compliance with post-operative guidelines, or satisfaction with support and communication from the surgical team.

LEVEL OF EVIDENCE: 1 - Randomized Control Trial (RCT).

PMID:34655765 | DOI:10.1016/j.arthro.2021.09.030