Nurse-Led Telehealth vs In-Person Follow-Up After Total Knee Replacement
NCT ID: NCT07058623
Last Updated: 2026-01-05
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
RECRUITING
NA
98 participants
INTERVENTIONAL
2025-09-10
2026-06-30
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
The goal of this clinical trial is to learn if nurse-led telehealth consultations can help detect complications and support recovery after total knee replacement surgery. The study will compare telehealth nursing consultations to traditional in-person nursing visits.
The main questions it aims to answer are:
* Can nurse-led telehealth detect post-surgery complications as well as or better than in-person consultations?
* Does telehealth nursing support better or equivalent recovery outcomes and patient satisfaction compared to in-person care?
Participants will:
* Be adults who had their first total knee replacement surgery.
* Receive follow-up care either through telehealth consultations using the HA Go mobile app or through traditional face-to-face nurse visits in the outpatient clinic.
* Attend scheduled consultations and provide information about their recovery and any complications they experience.
* Complete surveys about their satisfaction with the care they receive.
This study will help determine if telehealth nursing consultations can provide safe, effective, and convenient follow-up care for patients after knee replacement surgery, potentially improving access and reducing travel burdens.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Nurse Led Follow-up After Total Knee Arthroplasty
NCT01771315
Inpatient vs Outpatient Total Knee Replacement
NCT04228731
Progression of Health Related Quality of Life of Patients Waiting for Total Knee Arthroplasty
NCT03492320
Effectiveness of a Femoral Block Following Total Knee Arthroplasty (TKA)
NCT00659087
Prediction of Outcomes Following Total Knee Replacement- Pilot
NCT04328701
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Background and Rationale Total knee replacement is a common surgical intervention for end-stage knee osteoarthritis, offering significant pain relief and improved function. Post-operative follow-up is essential to monitor recovery, detect complications early, and support rehabilitation. However, traditional in-person consultations can pose logistical challenges for patients, including mobility limitations, travel burden, and time constraints. Telehealth has emerged as a promising alternative by enabling remote clinical assessments and patient monitoring, especially amplified by recent advances and adoption during the COVID-19 pandemic.
While telehealth models led by physicians have been studied extensively, there is a relative lack of evidence regarding nurse-led telehealth consultations in the orthopedic post-operative setting. Nurses play a crucial role in patient education, symptom monitoring, and care coordination, making nurse-led telehealth a potentially efficient and scalable solution. This study aims to fill this gap by rigorously evaluating whether nurse-led telehealth consultations can detect complications and support recovery as effectively as standard in-person visits.
Study Design
This is an open-label, parallel-group randomized controlled trial with two arms:
* Intervention arm: Nurse-led telehealth consultations delivered via a secure, hospital-approved mobile platform (the HA Go app).
* Control arm: Traditional in-person nursing consultations conducted at the Specialist Outpatient Department (SOPD).
Randomization will be performed using computer-generated block randomization with allocation concealment ensured through sealed opaque envelopes. Blinded outcome assessment and data analysis will be conducted to minimize bias.
Participants The trial will enroll adult patients (≥18 years old) who undergo first-time unilateral total knee replacement surgery at Tseung Kwan O Hospital. Eligible participants must be medically stable for discharge, have access to the necessary technology for telehealth, and provide informed consent. Patients with revision surgery, bilateral TKR, severe systemic disease (ASA Class III or above), or insufficient technological capacity will be excluded.
Interventions
Nurse-Led Telehealth:
Participants randomized to the telehealth arm will receive scheduled virtual consultations through the HA Go app. Consultations will include remote symptom assessment, wound evaluation via video, patient education on recovery and rehabilitation exercises, and management of minor complications. An executive assistant will provide technical support to patients unfamiliar with the app.
In-Person Nursing Consultation:
Participants assigned to the control group will attend face-to-face follow-up visits at the SOPD, receiving standard nursing care including physical examinations, education, and complication management.
Outcome Assessments The primary outcome is the rate of timely detection and management of post-operative complications within four weeks post-surgery. Secondary outcomes include functional recovery (assessed by validated scales such as KOOS), patient satisfaction, healthcare utilization (unplanned readmissions and emergency visits), and cost-effectiveness analyses encompassing travel and consultation time savings.
Data Collection and Management Data will be collected prospectively via electronic medical records, patient questionnaires, and telehealth system logs. Missing data will be managed using multiple imputation techniques under the assumption of missing at random. Security and confidentiality will be maintained according to Hospital Authority policies, with data encrypted and access restricted to authorized study personnel.
Significance By rigorously comparing nurse-led telehealth to traditional care, this study will generate high-quality evidence to inform post-operative management in TKR patients. Positive findings could support wider implementation of nurse-led telehealth services, improving accessibility, reducing patient burden, and optimizing healthcare resources. This model may be generalizable to other orthopedic and chronic disease care pathways.
Trial Registration and Ethics The study will be registered prior to recruitment, with ethical approval obtained from the Hospital Authority Central Institutional Review Board. Participants will provide informed consent, and the trial will adhere to CONSORT and Good Clinical Practice guidelines.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
RANDOMIZED
PARALLEL
Randomization is performed using block randomization with concealed allocation to ensure balance between groups and minimize selection bias.
TREATMENT
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Nurse-Led Telehealth Consultation
Participants receive postoperative nursing follow-up via virtual consultations using the HA Go mobile app, a secure, hospital-approved telehealth platform. Nurses monitor recovery, assess for complications, provide education, and manage minor issues remotely. Consultations are scheduled 2 weeks post-surgery, with additional sessions as clinically indicated, lasting approximately 20-30 minutes each. Support is provided to assist patients unfamiliar with the technology. This arm tests the effectiveness of remote nursing care compared to traditional in-person visits.
Nurse-Led Telehealth Consultation
Participants receive scheduled postoperative nursing consultations delivered remotely via the HA Go mobile application, a secure, hospital-approved telehealth platform. Consultations occur approximately two weeks after total knee replacement surgery, with additional sessions arranged as clinically needed within the first month post-surgery. Each telehealth session lasts about 20 to 30 minutes and includes assessment of recovery progress, monitoring for complications, patient education, and guidance on rehabilitation exercises. Patients receive technical support to facilitate effective use of the telehealth platform. This intervention leverages virtual care technology to provide convenient, accessible nursing follow-up without requiring in-person clinic visits.
Traditional In-Person Nursing Consultation
Participants attend face-to-face postoperative nursing consultations at the Specialist Outpatient Department. Nurses perform physical assessments, monitor recovery progress, detect complications, provide education, and manage minor issues in-person. Follow-up visits are scheduled 2 weeks after surgery, with additional visits as needed. Consultations typically last 20-30 minutes. This arm represents standard care and serves as the active comparator to the telehealth intervention.
Traditional In-Person Nursing Consultation
Participants receive scheduled postoperative nursing consultations in person at the Specialist Outpatient Department. Each consultation lasts approximately 20 to 30 minutes and includes physical assessment, monitoring for complications, patient education, and rehabilitation guidance. Follow-up visits are typically scheduled two weeks after total knee replacement surgery, with additional visits as clinically indicated. This intervention represents standard postoperative nursing care delivered face-to-face.
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Nurse-Led Telehealth Consultation
Participants receive scheduled postoperative nursing consultations delivered remotely via the HA Go mobile application, a secure, hospital-approved telehealth platform. Consultations occur approximately two weeks after total knee replacement surgery, with additional sessions arranged as clinically needed within the first month post-surgery. Each telehealth session lasts about 20 to 30 minutes and includes assessment of recovery progress, monitoring for complications, patient education, and guidance on rehabilitation exercises. Patients receive technical support to facilitate effective use of the telehealth platform. This intervention leverages virtual care technology to provide convenient, accessible nursing follow-up without requiring in-person clinic visits.
Traditional In-Person Nursing Consultation
Participants receive scheduled postoperative nursing consultations in person at the Specialist Outpatient Department. Each consultation lasts approximately 20 to 30 minutes and includes physical assessment, monitoring for complications, patient education, and rehabilitation guidance. Follow-up visits are typically scheduled two weeks after total knee replacement surgery, with additional visits as clinically indicated. This intervention represents standard postoperative nursing care delivered face-to-face.
Other Intervention Names
Discover alternative or legacy names that may be used to describe the listed interventions across different sources.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Undergoing their first total knee replacement surgery
* Within 4 weeks after surgery
* Medically stable for discharge and suitable for home-based follow-up care
* Have access to a smartphone and internet (for telehealth participants)
* Able to communicate effectively in Cantonese
* Provide informed consent to participate in the study
Exclusion Criteria
* Require immediate or intensive medical attention post-surgery (e.g., severe infection, hospitalization over 7 days)
* Have severe systemic disease (ASA physical status classification III or higher)
* Lack the technical ability or resources to participate in telehealth consultations
* Unable to communicate effectively in Cantonese
* Undergoing surgeries other than first-time total knee replacement
18 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Hospital Authority, Hong Kong
OTHER_GOV
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Wong King Sum
Associated Nurse Consultant (O&T)
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Tseung Kwan O Hospital
Hong Kong, , Hong Kong
Countries
Review the countries where the study has at least one active or historical site.
Central Contacts
Reach out to these primary contacts for questions about participation or study logistics.
Facility Contacts
Find local site contact details for specific facilities participating in the trial.
References
Explore related publications, articles, or registry entries linked to this study.
Zhao R, Cheng L, Zheng Q, Lv Y, Wang YM, Ni M, Ren P, Feng Z, Ji Q, Zhang G. A Smartphone Application-Based Remote Rehabilitation System for Post-Total Knee Arthroplasty Rehabilitation: A Randomized Controlled Trial. J Arthroplasty. 2024 Mar;39(3):575-581.e8. doi: 10.1016/j.arth.2023.08.019. Epub 2023 Aug 11.
Windsor EN, Sharma AK, Gkiatas I, Elbuluk AM, Sculco PK, Vigdorchik JM. An Overview of Telehealth in Total Joint Arthroplasty. HSS J. 2021 Feb;17(1):51-58. doi: 10.1177/1556331620972629. Epub 2021 Feb 21.
Visperas AT, Greene KA, Krebs VE, Klika AK, Piuzzi NS, Higuera-Rueda CA. A Web-Based Interactive Patient-Provider Software Platform Does Not Increase Patient Satisfaction or Decrease Hospital Resource Utilization in Total Knee and Hip Arthroplasty Patients in a Single Large Hospital System. J Arthroplasty. 2021 Jul;36(7):2290-2296.e1. doi: 10.1016/j.arth.2021.01.037. Epub 2021 Jan 21.
Shan Y, Ji M, Xie W, Li R, Qian X, Zhang X, Hao T. Chinese Version of the Mobile Health App Usability Questionnaire: Translation, Adaptation, and Validation Study. JMIR Form Res. 2022 Jul 6;6(7):e37933. doi: 10.2196/37933.
Pitaro NL, Barbera JP, Ranson WA, Zubizarreta N, Poeran J, Chen DD, Moucha CS, Hayden BL. Evaluating Resource Utilization for In-Person and Virtual Joint Classes in Total Joint Arthroplasty: An Analysis of Attendance Patterns at a Large Metropolitan Health System. J Arthroplasty. 2022 Sep;37(9):1708-1714. doi: 10.1016/j.arth.2022.03.079. Epub 2022 Apr 1.
McKeon JF, Alvarez PM, Vajapey AS, Sarac N, Spitzer AI, Vajapey SP. Expanding Role of Technology in Rehabilitation After Lower-Extremity Joint Replacement: A Systematic Review. JBJS Rev. 2021 Sep 13;9(9). doi: 10.2106/JBJS.RVW.21.00016.
Hofmann UK, Hildebrand F, Mederake M, Migliorini F. Telemedicine in orthopaedics and trauma surgery during the first year of COVID pandemic: a systematic review. BMC Musculoskelet Disord. 2023 Feb 7;24(1):101. doi: 10.1186/s12891-023-06194-3.
Fahey E, Elsheikh MFH, Davey MS, Rowan F, Cassidy JT, Cleary MS. Telemedicine in Orthopedic Surgery: A Systematic Review of Current Evidence. Telemed J E Health. 2022 May;28(5):613-635. doi: 10.1089/tmj.2021.0221. Epub 2021 Aug 10.
Fabres Martin C, Ventura Parellada C, Herrero Anton de Vez H, Ordonez Urgiles CE, Alonso-Rodriguez Piedra J, Mora Guix JM. Telemedicine approach for patient follow-up after total knee and reverse total shoulder arthroplasty: a pilot study. Int J Comput Assist Radiol Surg. 2023 Mar;18(3):595-602. doi: 10.1007/s11548-022-02784-z. Epub 2022 Nov 23.
El Ashmawy AH, Dowson K, El-Bakoury A, Hosny HAH, Yarlagadda R, Keenan J. Effectiveness, Patient Satisfaction, and Cost Reduction of Virtual Joint Replacement Clinic Follow-Up of Hip and Knee Arthroplasty. J Arthroplasty. 2021 Mar;36(3):816-822.e1. doi: 10.1016/j.arth.2020.08.019. Epub 2020 Aug 15.
Bovonratwet P, Song J, LaValva SM, Chen AZ, Ondeck NT, Blevins JL, Su EP. Telemedicine in Arthroplasty Patients: Which Factors Are Associated With High Satisfaction? Arthroplast Today. 2024 Jan 2;25:101285. doi: 10.1016/j.artd.2023.101285. eCollection 2024 Feb.
American Academy of Orthopaedic Surgeons. (2024). Total knee replacement. OrthoInfo. Retrieved January 8, 2025, from https://orthoinfo.aaos.org/en/treatment/total-knee-replacement
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
TKR-TEL-2025-TKOH
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.