Purpose
To assess an automated text-messaging system for patients after hip arthroscopy and
its impact at 90 days on the Hip Disability Osteoarthritis Outcome Score Physical
Function Short form (HOOS-PS, HOOS-Pain), compliance with rehabilitation guidelines,
and patient satisfaction.
Methods
One hundred twenty-one participants (average age 29 ± 8.7 years, 52% female) undergoing
hip arthroscopy at 2 academic institutions were prospectively enrolled and randomized
to receive (1) standard perioperative communication or (2) additional automated mobile
phone text messages. Inclusion criteria included ability to communicate in written
English and access to a mobile phone with text-messaging capability. Patients undergoing
revision surgery or simultaneous femoral or acetabular osteotomy were excluded. HOOS-PS
and HOOS-Pain were collected preoperatively, and after surgery an automated mobile
phone robot sent participants in the therapeutic arm intermittent text messages for
90 days. At 90 days all participants again completed HOOS-PS, HOOS-Pain, and additional
survey questions on satisfaction with their experience (10-point scale), communication
from the surgical team (10-point scale) and adherence to physical therapy exercises,
weight-bearing guidelines, and brace use, The primary outcome assessed was a statistically
significant change in HOOS-PS and HOOS-Pain; secondary outcomes included change in
satisfaction, communication, and adherence to physical therapy exercises, weightbearing
guidelines, or brace use. Wilcoxon rank sum was used to compare HOOS-PS and HOOS-Pain
scores at 0 and 90 days. Demographic characteristics and survey variables were compared
using Students t test for continuous variables and χ2 or Fisher exact test for categorical variables as appropriate.
Results
There were statistically significant and clinically relevant improvements in HOOS-PS
and HOOS-Pain in both groups (P < .05). Subjective feedback was strongly positive, with 96% of text message participants
reporting they would choose automated messages if it was offered to them again in
the future.
Conclusions
Ninety days of automated text messaging after hip arthroscopy failed to show a significant
difference in HOOS-PS (P = .09), HOOS-Pain (P = .13), patient-reported compliance with postoperative guidelines, or satisfaction
with support and communication from the surgical team.
Level of Evidence
I, randomized control trial (RCT).
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Article info
Publication history
Published online: October 12, 2021
Accepted:
September 28,
2021
Received:
February 5,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: E.J.S. reports reviewer and social media board member for Arthroscopy. T.S.L. reports personal fees from Smith & Nephew, Arthrex, and ConMed, outside the submitted work. R.W.W. reports other from Arthroscopy, American Journal of Sports Medicine, American Orthopaedic Society for Sports Medicine, and ConMed Linvatec; and nonfinancial support from Smith & Nephew, outside the submitted work. This study was funded by a grant from the Arthroscopy Association of North America in 2018 titled “Improving Post-Operative Hip Arthroscopy Protocol Compliance: An Interactive Cellular-Phone Based Information System.” Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2021 by the Arthroscopy Association of North America
