Arthroplasty Care Practitioner's Association. Promoting quality care for arthroplasty patients. 2013. (accessed 10 October 2019)

British Association of Knee Surgery, British Orthopaedic Association, Royal College of Surgeons of England. Commissioning guide: painful osteoarthritis of the knee. 2017. (accessed 10 October 2019)

British Hip Society, British Orthopaedic Association, Royal College of Surgeons of England. Commissioning guide: pain arising from the hip in adults. 2017. (accessed 10 October 2019)

British Orthopaedic Association. Primary total hip replacement: a guide to good practice. 2012. (accessed 18 October 2018)

Beard DJ, Harris K, Dawson J Meaningful changes for the Oxford hip and knee scores after joint replacement surgery. J Clin Epidemiol. 2015; 68:(1)73-79

Culliford D, Maskell J, Judge A Future projections of total hip and knee arthroplasty in the UK: results from the UK Clinical Practice Research Datalink. Osteoarthr Cartil. 2015; 23:(4)594-600

Health Education England. Multi-professional framework for England. 2019. (accessed 10 October 2019)

Kingsbury SR, Dube B, Thomas CM, Conaghan PG, Stone MH. Is a questionnaire and radiograph-based follow-up model for patients with primary hip and knee arthroplasty a viable alternative to traditional regular outpatient follow-up clinic?. Bone Joint J. 2016; 98-B:(2)201-208

Murray DW, Fitzpatrick R, Rogers K The use of the Oxford hip and knee scores. J Bone Joint Surg Br. 2007; 89:(8)1010-1014

National Joint Registry. 14th annual report. 2017. (accessed 10 October 2019)

Roberts N, Mujica-Mota R, Williams D. The cost of improving hip replacement follow-up in the UK. Musculoskeletal Care. 2016; 14:(2)116-120

Skills for Health. Competences tools. Role ID_0103. Advanced practitioner MSK, arthroplasty, hip and knee. 2014. (accessed 10 October 2019)

Wainwright C, Theis JC, Garneti N, Melloh M. Age at hip or knee joint replacement surgery predicts likelihood of revision surgery. J Bone Joint Surg Br. 2011; 93:(10)1411-1415

Setting up an arthroplasty care practitioner-led virtual clinic for follow-up of orthopaedic patients

14 November 2019
Volume 28 · Issue 20


This article provides an overview of the set up for an arthroplasty care practitioner (ACP)-led virtual orthopaedic clinic (VOC). Suitable patients attend a local hospital for an X-ray and complete a questionnaire, but do not physically attend a clinic. This has been running successfully in a university teaching hospital and has led to cost savings, a reduction in outpatient waiting times and high levels of patient satisfaction. Similar clinics have the potential to become normal practice across the NHS. This article outlines the steps necessary to implement a successful VOC. The lessons learnt during this exercise may be useful for other ACPs when setting up a VOC.

More than 200 000 primary hip and knee replacement procedures are carried out every year in the UK and the numbers are rising (National Joint Registry, 2017). With growing demand and increased life expectancy, it is expected that the need for hip and knee replacements may increase by more than 600% by the year 2030 (Culliford et al, 2015).

Currently, the guidelines recommend routine follow-up of hip replacements at years 1, 7 and 10 and every 3 years thereafter (British Hip Society et al, 2017). For knees, the recommended intervals are years 1 and 7, and every 3 years thereafter (British Association of Knee Surgery et al, 2017). This is, in part, to ensure that patients do not have any ongoing problems related to their replaced joints and, if they do, a timely and appropriate intervention is planned. With increasing use of joint replacement in young and active patients who tend to have higher expectations as well as higher revision rates, regular follow-up is crucial.

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content