Conventional Follow-up Versus Mobile App Home Monitoring for Post-Operative ACL Reconstruction Patients: A Randomized Controlled Trial.

PURPOSE: To determine whether a mobile app can reduce the need for in-person visits and examine the resulting societal cost differences between mobile and conventional follow-up for post-operative ACL reconstruction patients. METHODS: Study design was a single-centre, two-arm parallel group randomized controlled trial. All patients undergoing ACL reconstruction aged 16-70 were screened for inclusion in the study. Competent use of a mobile device and ability to communicate in English was required. Patients were randomly assigned to receive follow-up via a mobile app or through conventional appointments. Analysis was intention-to-treat. The primary outcome was the number of in-person visits to any healthcare professional during the first six post-operative weeks. Secondary outcomes included analysis of costs incurred by the healthcare system and personal patient costs related to both methods of follow-up. Patient-reported satisfaction and convenience scores, rates of complications, and clinical outcomes were also analyzed. RESULTS: Sixty patients were analyzed. Participants in the app group attended a mean of 0.36 in-person visits versus 2.44 in-person visits in the conventional group (95% CI 0.08-0.28; P<0.0001). On average, patients in the app group spent CAD $211 less than the conventional group over 6 weeks (p<0.0001) on personal costs related to follow-up. Healthcare system costs were also significantly less in the app group (CAD $157.5 versus CAD $202.2; p<0.0001). There was no difference between groups in patient satisfaction, convenience, complication rates, or clinical outcome measures. CONCLUSIONS: Mobile follow-up can eliminate a significant number of in-person visits during the first six post-operative weeks in patients undergoing ACL reconstruction with cost savings to both the patient and healthcare system. This method should be considered for dissemination among similar orthopaedic procedures during early post-operative care.