Table 2.
Surgical plan change
| Specialty | Virtual visit plan | Change after in-person visit | Reason for change |
|---|---|---|---|
| Sports | ACL reconstruction w/autograft | ACL reconstruction w/allograft | Patient preference |
| Sports | TTO with medialization and distalization, MPFL reconstruction, trochleoplasty | No distalization needed | Physical examination revealed patella alta was not as significant as expected |
| Sports | Knee arthroscopy | Knee arthroscopy, loose body removal, MACI biopsy | Additional components added to surgical plan |
| UE/shoulder | Ulnar collateral ligament reconstruction | Ulnar collateral ligament reconstruction with hamstring autograft, ulnar nerve transposition | Physical examination revealed poor palmaris autograft potential and subluxating ulnar nerve |
| UE/shoulder | Revision rotator cuff repair | Added consideration for lower trapezius tendon transfer based on intraoperative findings | Physical exam revealed significant external rotation weakness |
| UE/shoulder | Rotator cuff repair | Added subacromial decompression and subpectoral biceps tenodesis | Physical examination revealed biceps tenderness |
| Spine | L3–L5 laminectomy and non-instrumented fusion | Extended to include L2–L3 | Re-review of prior MRI |
| Spine | C4–C5 ACDF | Extended to include C3–C4 | New C spine radiographs revealed more prominent degenerative findings |
| Spine | L5–S1 foraminotomy vs TLIF | Committed to TLIF | Patient preference after in-person visit |
| Spine | C2 laminectomy, C2-T2 fusion | Extended laminectomy to include C3–C6 | Additional specific decompression levels added to surgical plan |
| Spine | Sacral laminectomy, radiation, 2-stage en bloc spondylectomy | Abandoned initial sacral laminectomy, converted to neoadjuvant XRT prior to 2-stage en bloc spondylectomy | Lack of clarity in virtual visit |
Breakdown of cases with change to surgical plan for patients initially scheduled for surgery after virtual visit only. Attending surgeon reported justification for change in surgical plan located in right-most column
UE upper extremity, ACL anterior cruciate ligament, TTO tibial tubercle osteotomy, MPFL medial patellofemoral ligament, MACI matrix-induced autologous chondrocyte implantation, ACDF anterior cervical discectomy and fusion, TLIF transforaminal lumbar interbody fusion, PSIF posterior spinal instrumented fusion, XRT external-beam radiation therapy