INITIATION OF A NOVEL TEXT MESSAGING SYSTEM IN TOTAL KNEE AND HIP ARTHROPLASTY

The primary objective of this study is to investigate whether using the novel text messaging system improves patient satisfaction compared to standard care. Secondary objectives include assessing the impact of the text messaging system on narcotic usage, the number of emergency department visits, flexion and extension of total knee replacements and number of telephone calls to the surgeon's office. We enrolled 246 patients in this non randomized controlled trial. One hundred thirty-one patients (76 males; 55 females) did not receive text messages (conventional group) while 115 (79 males; 36 females) patients did receive text messages (text messaging group). The intervention group received text messages perioperatively in addition to standard of care, while the control group only continued on with standard of care practises. Questionnaires were filled out at the 6 weeks mark. A comparative analysis of demographic characteristics among the investigated cohorts was undertaken to identify potential statistically significant disparities in group composition. Depending on the nature of the variables under comparison, either Fisher's exact test or Student's t-test was employed. The results of the implementation of the new text message system across the examined groups were compared using Fisher's exact test or Mann–Whitney U test, selected in accordance with the data type. All the selected methodologies represent established instruments for detecting pertinent distinctions between groups. There was no difference in satisfaction rates between the two groups (p=0.644). In regards to the secondary objectives, there was a statistically significant difference in favour of the text messaging group with telephone calls to the surgeon's office (p=0.029). No difference was found in emergency department visits (p=0.065) or duration of narcotic usage (p=0.185). There was no difference in flexion (p=0.521) and extension (p=0.515) measurements for the total knee replacements. Subgroup analysis comparing the TKA and THA separately demonstrated no statistical difference between the primary and secondary objectives except for telephone calls to the surgeons office which favoured the TKA group(p=0.046). There was no difference between primary and secondary objectives looking at patients that received text messages prior to their joint replacements compared to patients only receiving text messages starting on the day of surgery. This was a similar finding looking at patients that opted out of the text messaging system before 6 weeks compared to patients that continued with the text messaging system until the 6 week follow up. Instituting a novel text messaging system can be very useful in reducing the work burden by decreasing telephone calls to the surgeon's office. Even though there wasn't a statistically significant difference in satisfaction rates, duration of narcotic usage, range of motion of total knee replacements between the intervention and control group, all patients would recommend it to friends or family.