The Hidden Cost of Routine Post-Op Visits: Why 1-Year PROMs Are Sufficient

How the COVID-19 pandemic highlighted the unnecessary burden of routine asymptomatic surveillance visits on both patients and healthcare systems.

Total knee arthroplasty (TKA) outcomes are frequently assessed with patient-reported outcome measures (PROMs). Collection of PROMs is often performed prospectively before and after surgery at various follow-up intervals. Collection of PROMs adds additional cost and burden to patients and clinical staff, with one study finding that maximal effort in PROM collection led to a 76% response rate, compared to 44% with minimal effort or automated collection.

Nonetheless, PROMs have become an important tool in clinical research, with retrospective and prospective studies utilizing PROMs as primary or secondary outcomes. Many orthopedic surgery journals require a minimum of 2-year follow-up for publication of clinical research, accentuating the burden of PROM data collection. This minimum requirement for follow-up has evolved from implant survivorship studies, and the value and necessity of long-term PROM collection are yet to be fully understood. While most agree that patient follow-up and surveillance are critical, the utility of long-term PROMs remains uncertain.