Telehealth interventions on pain in postoperative orthopedic surgery patients: A systematic review
DOI:
https://doi.org/10.35335/midwifery.v13i3.2014Keywords:
Orthopedic Surgery, Pain Management, Postoperative Care, TelehealthAbstract
This systematic review evaluates the effectiveness of telehealth interventions in managing pain among postoperative orthopedic surgery patients. The introduction highlights the transformative potential of digital health technologies, such as telemedicine and mobile health applications, in improving access, quality, and efficiency of healthcare, particularly for pain management and patient adherence. The methods section outlines a structured literature search across Scopus, PubMed, and Proquest databases, adhering to PRISMA guidelines, with inclusion criteria focusing on randomized controlled trials (RCTs) and quasi-experimental studies involving adult orthopedic patients aged 18–60 years. Ten studies met the criteria, demonstrating varied telehealth approaches, including mobile apps, video consultations, and remote monitoring. Results indicate significant pain reduction and improved clinical outcomes in telehealth groups compared to standard care, with enhanced patient adherence, functional recovery, and reduced opioid use. However, variability in intervention duration and pain measurement tools underscores the need for standardization. The conclusion affirms telehealth as a valuable tool for postoperative pain management, emphasizing its role in education, monitoring, and psychosocial support. Future research should explore combined interventions and economic impacts to optimize implementation.
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Anthony, C. A., Rojas, E. O., Keffala, V., Glass, N. A., Shah, A. S., Miller, B. J., Hogue, M., Willey, M. C., Karam, M., & Marsh, J. L. (2020). Acceptance and Commitment Therapy Delivered via a Mobile Phone Messaging Robot to Decrease Postoperative Opioid Use in Patients With Orthopedic Trauma: Randomized Controlled Trial. Journal of Medical Internet Research, 22(7), e17750. https://doi.org/10.2196/17750
Barker, T. H., Stone, J. C., Sears, K., Klugar, M., Tufanaru, C., Leonardi-Bee, J., Aromataris, E., & Munn, Z. (2023). The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evidence Synthesis, 21(3), 494–506. https://doi.org/10.11124/JBIES-22-00430
Blasco, J.-M., DÃÂÂaz-DÃÂÂaz, B., Igual-Camacho, C., Pérez-Maletzki, J., Hernández-Guilén, D., & Roig-Casasús, S. (2023). Effectiveness of using a chatbot to promote adherence to home physiotherapy after total knee replacement, rationale and design of a randomized clinical trial. BMC Musculoskeletal Disorders, 24(1), 491. https://doi.org/10.1186/s12891-023-06607-3
Brink, H., & Van der Walt, C. (2006). Fundamentals of Research Methodology for Health Care Professionals. Juta.
Buvik, A., Bugge, E., Knutsen, G., Småbrekke, A., & Wilsgaard, T. (2019). Patient reported outcomes with remote orthopaedic consultations by telemedicine: A randomised controlled trial. Journal of Telemedicine and Telecare, 25(8), 451–459. https://doi.org/10.1177/1357633X18783921
Campbell, R., Podugu, S. D. V. P. R., & Morris, M. (2025). Online Acceptance and Commitment Therapy for Chronic Pain in an Older Adult: A Telehealth Approach Amid COVID-19. Clinical Gerontologist. https://doi.org/10.1080/07317115.2025.2487008
Carroll, I., Hah, J., Mackey, S., Ottestad, E., Kong, J. T., Lahidji, S., Tawfik, V., Younger, J., & Curtin, C. (2013). Perioperative interventions to reduce chronic postsurgical pain. Journal of Reconstructive Microsurgery, 29(4), 213–222. https://doi.org/10.1055/s-0032-1329921
Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness, L. A. (2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020â€ÂÂcompliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews, 18(2), e1230.
Hou, J., Yang, R., Yang, Y., Tang, Y., Deng, H., Chen, Z., Wu, Y., & Shen, H. (2019). The Effectiveness and Safety of Utilizing Mobile Phone-Based Programs for Rehabilitation After Lumbar Spinal Surgery: Multicenter, Prospective Randomized Controlled Trial. JMIR MHealth and UHealth, 7(2), e10201. https://doi.org/10.2196/10201
Kane, L. T., Thakar, O., Jamgochian, G., Lazarus, M. D., Abboud, J. A., Namdari, S., & Horneff, J. G. (2020). The role of telehealth as a platform for postoperative visits following rotator cuff repair: a prospective, randomized controlled trial. Journal of Shoulder and Elbow Surgery, 29(4), 775–783. https://doi.org/10.1016/j.jse.2019.12.004
Kneuertz, P. J., Jagadesh, N., Perkins, A., Fitzgerald, M., Moffatt-Bruce, S. D., Merritt, R. E., & D’Souza, D. M. (2020). Improving patient engagement, adherence, and satisfaction in lung cancer surgery with implementation of a mobile device platform for patient reported outcomes. Journal of Thoracic Disease, 12(11), 6883 – 6891. https://doi.org/10.21037/jtd.2020.01.23
Limna, P. (2023). The Digital Transformation of Healthcare in The Digital Economy: A Systematic Review. International Journal of Advanced Health Science and Technology, 3(2), 127–132. https://doi.org/10.35882/ijahst.v3i2.244
Martinez-Rico, S., Lizaur-Utrilla, A., Sebastia-Forcada, E., Vizcaya-Moreno, M. F., & de Juan-Herrero, J. (2018). The Impact of a Phone Assistance Nursing Program on Adherence to Home Exercises and Final Outcomes in Patients Who Underwent Shoulder Instability Surgery: A Randomized Controlled Study. Orthopedic Nursing, 37(6), 372–378. https://doi.org/10.1097/NOR.0000000000000501
MAULA, D. R. (2020). PROPOSAL PENGEMBANGAN INOVASI KEPERAWATAN MEDIKAL BEDAH: COVID-19.
Pamungkas, K. M. N., Dewi, P. I. S. L., Dyatmika, I. K. W. P., Maharjana, M. A., & Meregawa, P. F. (2022). The impact of the Covid-19 pandemic on trauma cases in the orthopedics and traumatology services: A systematic review. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 13(1). https://doi.org/10.20885/JKKI.Vol13.Iss1.art11
Pronk, Y., Peters, M. C. W. M., Sheombar, A., & Brinkman, J.-M. (2020). Effectiveness of a Mobile eHealth App in Guiding Patients in Pain Control and Opiate Use After Total Knee Replacement: Randomized Controlled Trial. JMIR MHealth and UHealth, 8(3), e16415. https://doi.org/10.2196/16415
Sitorus, R. (2024). Model bisnis berkelanjutan dan strategi bersaing rumah sakit dalam era digital: Literature review. J-CEKI: Jurnal Cendekia Ilmiah, 4(1), 753–764.
Stuhlreyer, J., Roder, C., Krug, F., Zöllner, C., Flor, H., & Klinger, R. (2022). A digital application and augmented physician rounds reduce postoperative pain and opioid consumption after primary total knee replacement (TKR): a randomized clinical trial. BMC Medicine, 20(1), 469. https://doi.org/10.1186/s12916-022-02638-0
Timmers, T., Janssen, L., van der Weegen, W., Das, D., Marijnissen, W.-J. J., Hannink, G., van der Zwaard, B. C., Plat, A., Thomassen, B., Swen, J.-W. W., Kool, R. B., Lambers Heerspink, F. O., Heerspink, F. O. L., & Lambers Heerspink, F. O. (2019). The Effect of an App for Day-to-Day Postoperative Care Education on Patients With Total Knee Replacement: Randomized Controlled Trial. JMIR MHealth and UHealth, 7(10), e15323. https://doi.org/10.2196/15323
Tsang, M. P., Man, G. C. W., Xin, H., Chong, Y. C., Ong, M. T.-Y., & Yung, P. S.-H. (2024). The effectiveness of telerehabilitation in patients after total knee replacement: A systematic review and meta-analysis of randomized controlled trials. Journal of Telemedicine and Telecare, 30(5), 795 – 808. https://doi.org/10.1177/1357633X221097469
UNIVERSITI, P. P. M. S., & ALI, I. S. S. (n.d.). PEMBEDAHAN PLASTIK DALAM MAZHAB SYAFI ‘I: KAJIAN PERBANDINGAN FATWA-FATWA DI BRUNEI DARUSSALAM DAN INDONESIA.
Vanderstappen, M., van Ochten, J. H. M., & Verborgt, O. (2025). Robotics in arthroplasty: how good are they? JSES International, 9(3), 968–973. https://doi.org/10.1016/j.jseint.2024.09.005
Wang, Q., Hunter, S., Lee, R. L.-T., & Chan, S. W.-C. (2023a). The effectiveness of a mobile application-based programme for rehabilitation after total hip or knee arthroplasty: A randomised controlled trial. International Journal of Nursing Studies, 140, 104455. https://doi.org/10.1016/j.ijnurstu.2023.104455
Wang, Q., Hunter, S., Lee, R. L. T., & Chan, S. W. C. (2023b). The effectiveness of a mobile application-based programme for rehabilitation after total hip or knee arthroplasty: A randomised controlled trial. International Journal of Nursing Studies, 140, 104455. https://doi.org/10.1016/j.ijnurstu.2023.104455
Zhao, R., Cheng, L., Zheng, Q., Lv, Y., Wang, Y.-M., Ni, M., Ren, P., Feng, Z., Ji, Q., & Zhang, G. (2024). A Smartphone Application-Based Remote Rehabilitation System for Post-Total Knee Arthroplasty Rehabilitation: A Randomized Controlled Trial. The Journal of Arthroplasty, 39(3), 575-581.e8. https://doi.org/10.1016/j.arth.2023.08.019


