Female Gender Is Associated with Lower Satisfaction with Postoperative Telemedicine Visits in Sports Medicine.

Introduction: Telemedicine is a relatively new adjunct in orthopedic care but it has emerged from the periphery, driven in part by the COVID-19 pandemic. Although it has drastically increased in use, little is known of the factors that drive satisfaction with telemedicine. The purpose of the current study was to evaluate the patient's satisfaction with postoperative telemedicine visits in those undergoing knee or shoulder arthroscopy, and to analyze the factors associated with satisfaction with telemedicine. Methods: A prospective study was performed to evaluate satisfaction comparing postoperative telemedicine and in-office visits, in those undergoing shoulder and knee arthroscopy. Multiple factors were analyzed for correlation with satisfaction via multi-linear regression, including demographics such as gender, education, age, and race. Patients were also evaluated for preference for future visits with reference to the group in which they were placed. Results: Overall, 215 patients were included with a subgroup analysis of 93 patients receiving telemedicine visits. Patients reported overall similar satisfaction with telemedicine visits after shoulder and knee arthroscopy, with a high level of satisfaction seen in both. Female sex was found to be associated with decreasing satisfaction with telemedicine visits (p = 0.036). In addition, as a whole, the cohort was found to prefer future visits to be the same as the group they were placed in, but females statistically did not have this preference for their familiar group and were skewed toward the preference of in-person visits (p = 0.377). Conclusions: Our study found that female patients were less likely to be satisfied with postoperative telemedicine visits after knee or shoulder arthroscopy. Further, females were also less likely to indicate preference for future telemedicine visits. In contrast, education, history of prior surgery, age, and race were not associated with postoperative satisfaction.

Return to Play Following COVID-19 Infection-A Systematic Review of Current Evidence.

CONTEXT: The COVID-19 pandemic has had catastrophic impact on a global scale, affecting people from all walks of life including elite athletes. OBJECTIVES: The purpose of this study was to evaluate the reported rates of return to play (RTP) in conjunction with the expert-derived guidelines previously recommended to enable safe RTP post COVID-19 infection. EVIDENCE ACQUISITION: Two independent reviewers searched the literature based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing the MEDLINE, Embase, and Scopus databases. Only studies that reported rates of RTP and/or recommended guidelines for safe RTP were included. EVIDENCE SYNTHESIS: Overall, 17 studies (3 level III and 14 level V) were included. A total of 3 studies reported rates of RTP in a total of 1255 athletes and 623 officials; 72 (30 symptomatic) were infected with COVID-19, 100% of whom were able to RTP post COVID-19 infection. Of the 14 studies recommending guidelines for safe RTP, 3 and 9 studies recommended 7 and 14 days of rest in isolation respectively for asymptomatic patients with COVID-19 infection, prior to safe RTP. In contrast, 7 studies recommended 3 to 6 months of rest (following 14 d isolation) in cases of COVID-19-induced myocarditis as a safe timeframe for safe RTP. Of the 11 studies reporting on whether blanket testing prior to RTP was recommended, only 7 studies recommended a negative test result as mandatory prior to RTP for athletes previously infected with COVID-19. CONCLUSIONS: Although excellent rates of RTP have been reported for elite athletes post COVID-19 infection, discrepancies in recommended rest periods, requirement for mandatory negative test results, and the magnitude of screening investigations required continue to exist in the literature, with a need for further standardized international guidelines required in future. LEVEL OF EVIDENCE: Level V; systematic review of all forms of evidence.

The Use and Acceptance of Telemedicine in Orthopedic Surgery During the COVID-19 Pandemic.

Background:A major byproduct of the recent coronavirus disease 2019 (COVID-19) pandemic has been the accelerated adoption of telemedicine within orthopedic practices.Introduction:The purpose of the study is to evaluate satisfaction associated with telemedicine and to determine how telemedicine is used by orthopedic surgeons in response to social distancing efforts necessitated by the COVID-19 pandemic.Methods:We developed a survey to evaluate surgeon's perception of telemedicine during the COVID-19 pandemic. The survey consisted of four major sections focusing on (1) surgeon characteristics and current use of telemedicine, (2) telemedicine for new patients, (3) telemedicine for routine follow-up patients, and (4) telemedicine for postoperative patients.Results:We collected 268 survey responses. Overall, 84.8% of surgeons were using telemedicine, but only 20.5% of surgeons were using it before the COVID-19 pandemic. The overall satisfaction with telemedicine was 70.3% ± 20.9%. Of those who use telemedicine, 75% currently use it for new patients, 86.6% currently use it for routine follow-up patients, and 80.8% currently use it for postoperative patients (p = 0.01). Surgeons had higher satisfaction with building rapport and performing physical examination maneuvers for either routine follow-up or postoperative patients than for new patients (p < 0.0001 for both). However, satisfaction with obtaining imaging did not differ among the cohorts (p = 0.36). Surgeons felt they are more likely to continue to use telemedicine after the COVID-19 pandemic for either routine follow-up or postoperative patients than for new patients (p < 0.0001).Discussion:Owing to challenges posed by the COVID-19 pandemic, telemedicine use has increased substantially among orthopedic surgeons in recent months.Conclusions:Our study established that physician implementation of telemedicine has increased significantly as a result of the COVID-19 pandemic, with the majority of surgeons satisfied with its use in their practice, and plan on incorporating telemedicine in their practices beyond the pandemic.

Resident, Fellow, and Attending Perception of E-Learning During the COVID-19 Pandemic and Implications on Future Orthopaedic Education.

INTRODUCTION: The purpose of the current study was to evaluate resident, fellow, and attending perspectives on the use of e-learning as part of orthopaedic surgery education. METHODS: A survey was created evaluating (1) overall attitudes toward e-learning, (2) multi-institutional e-learning/e-conferences, (3) national/regional e-conferences, and (4) future directions with e-learning. The survey was distributed to all the orthopaedic surgery residency program directors in the United States, and they were asked to circulate the survey to their program's faculty and trainees. RESULTS: A total of 268 responses were collected, including 100 attendings and 168 trainees. Overall satisfaction with e-learning compared with in-person learning was higher among trainees than attending faculty, with 51.4% of trainees favoring e-learning, as opposed to 32.2% of attendings (P = 0.006). Both groups felt they were more likely to pay attention with in-person learning (P = 0.89). During the COVID-19 pandemic, 85.7% of residents have used e-learning platforms to join a conference in their specialty of interest while off-service. Most attendings and trainees felt e-learning should play a supplemental role in standard residency/fellowship education, with a low number of respondents feeling that it should not be used (86.6% versus 84%, and 2.1% versus 0.6%, respectively, P = 0.28). CONCLUSION: E-learning has been an important modality to continue academic pursuits during the disruption in usual education and training schedules during the COVID-19 pandemic. Most trainees and attendings surveyed felt that e-learning should play a supplementary role in resident and fellow education moving forward. Although e-learning does provide an opportunity to hold multi-institutional conferences and makes participation in meetings logistically easier, it cannot fully replicate the dynamic interactions and benefits of in-person learning.