Table 2.

Summary of study characteristics and extracted data.

Author/ year	Type of study	Telemedicine setting	Number of patients	Patient population	Themes assessed	Findings
Kane et al., 202014	RCT	Home telemedicine vs. F2F	58	Post-operative arthroscopic rotator cuff repair patients	Patient safety & outcomes	No significant difference in post-operative pain scores (p = 0.95) or ROM (p≥0.37). No significant difference in post-operative complications.
					Clinician & patient satisfaction	No significant difference in patient satisfaction scores (p = 0.30). Significantly less time spent with telemedicine appointments (21.4 vs. 37.8 minutes). Telemedicine patients reported less time off work, less time waiting and preferred further follow-up using telemedicine. No significant difference in clinician satisfaction with entire telemedicine consult (p = 0.71).
Sultan et al., 202026	Cross-sectional	Home telemedicine	189	Paediatric spinal deformity vs. general paediatric patients	Patient satisfaction	Patients reported high satisfaction scores in both paediatric spinal deformity and general paediatric patients (5.0 ±0 vs. 4.8±0.1 points, p = 0.08). Patients had significantly shorter waiting times with telemedicine compared with F2F (13 vs. 41mins, p<0.001).
Silva et al., 201915	RCT	Home telemedicine (at 4-week follow-up) vs. F2F (all follow-ups)	57	Paediatric humerus supracondylar fractures	Patient satisfaction	No significant difference in patient satisfaction scores (p = 0.12).
					Patient safety & outcomes	No evidence of fracture displacement in either group or significant difference in Baumann’s angle (p = 0.09), ROM (p = 0.5), carrying angle (p = 0.11) or pain scores at 8-week follow-up (p = 0.1).
Buvik et al., 201916	RCT	Remote hospital joint telemedicine (nurse assisted) vs. F2F	389	General orthopaedic pathology	Patient satisfaction	No significant difference in patient satisfaction between two groups (p = 0.57). Those preferring telemedicine preferred the shorter travel time. Those preferring face to face wanted to see their specialist in person. Telemedicine patients had significantly shorter appointment waiting times.
					Patient safety & outcomes	No significant difference in EQ-5D (p = 0.42) and EQ-VAS (p = 0.053) scores at 12-month follow-up.
Goldstein et al., 201927	Cross-sectional	Smart phone telemedicine at hospital site (researcher assisted) vs. F2F	47	Adult shoulder pathology	Accuracy & validity of clinical examination	No clinically significant difference in mean measurement of Constant Shoulder scores (0.53, 95%CI –2.6 to 1.6) between two methods. Telemedicine can obtain reliable estimate of shoulder function.
Sinha et al., 201923	Cohort	Remote hospital joint telemedicine (PA assisted) vs. F2F	167	Paediatric fractures	Patient satisfaction	No significant difference in patient satisfaction between telemedicine and F2F (p = 0.07). More patients preferred to continue with telemedicine following an initial telemedicine consultation.
					Cost effectiveness	Statistically significant less direct and indirect costs reported by patients using telemedicine (p≤ 0.03).
Aponte-Tinao et al., 201928	Cross-sectional	Home telemedicine vs. F2F	207	New orthopaedic oncology referrals	Cost effectiveness	Telemedicine would reduce healthcare costs by 12.2%. For 36 patients who had to travel more than 400 km costs reduced by 72%.
Buvik et al., 201917	RCT	Remote hospital joint telemedicine (nurse assisted)  vs. F2F	389	General orthopaedic pathology	Cost effectiveness	€18,616 saved using telemedicine with a workload of 300 consultations per year. Minimum 151 and 183 telemedicine consultations required per year to be cost effective from societal and health care perspectives, respectively.
Abel et al., 201729	Cross-sectional	Home telemedicine vs. F2F	34	10–20yr olds post-knee arthroscopic surgery	Accuracy & validity of clinical examination	No clinically significant difference in assessment of ROM (p = 0.07), effusion, incision colour between two methods.
					Patient satisfaction	96% of patients were satisfied with telemedicine. Two-thirds of telemedicine patients wanted future telemedicine consultations.
Buvik et al., 201618	RCT	Remote hospital joint telemedicine  (nurse assisted) vs. F2F	389	General orthopaedic pathology	Clinician satisfaction	98 % of consultations with telemedicine and 99% F2F were rated as ‘good’ or ‘very good’.Three patients needed consultation F2F as physician was not satisfied with examination. No significant difference in mean consultation time (p = 0.6).
					Patient safety & outcomes	No significant difference in planned clinic outcomes; referral to surgery (p = 0.07), number of follow-ups (p = 0.06). No difference in serious events between two groups at 12-month follow-up (p = 0.26).
Sathiyakumar et al., 201519	RCT	Home telemedicine using Skype vs. F2F	17	Adult fracture follow-up	Patient satisfaction	No significant difference in patient satisfaction (p = 0.7). 75% of telemedicine patients preferred to continue with telemedicine follow-up.
					Patient safety & outcomes	One patient in each group had a complication. Pyelonephritis in the control group and a DVT in the telemedicine group.
Sharareh and Schwarzkopf, 201424	Cohort study	Home telemedicine using Skype vs. F2F	78	Post-operative hip and knee arthroplasty patients	Patient safety & outcomes	One patient in the telemedicine group suffered a femoral head dislocation during follow-up. No significant difference in HOOS (p = 0.21), KOOS (p = 0.37), EQ-5D (p = 0.41), SF-12 (p≥0.29) and UCLA activity score (p = 0.25) between two groups.
					Patient satisfaction	Higher average satisfaction rating with telemedicine (9.88 out of 10) compared with F2F consultations (average rating of 8.1 out of 10).
Good et al., 201130	Cross-sectional	Home telemedicine using Skype vs. F2F	29	Post-acromio-clavicular joint hook plate surgery for fractures	Accuracy & validity of clinical examination	No significant difference in measurement of Oxford Shoulder Score (–0.48, 95% CI –0.84 to –0.12) and Constant Shoulder scores (–0.68, 95% CI –1.08 to –0.29) between the two methods.
Williams et al., 200833	Case series	Telephone consultation	630	Post-operative carpal tunnel decompression	Patient satisfaction	93% of patients were satisfied with telephone follow-up. Patients commented on convenience and less time off work with telemedicine.
					Cost effectiveness	Cost saving of £45,958 over 2 years using telemedicine.
Vuolio et al., 200320	RCT	Remote primary care joint telemedicine (nurse and GP assisted) vs. F2F	145	General orthopaedic pathology including trauma	Patient safety & outcomes	No significant difference in planned clinic outcomes between two groups (referral for surgery, follow-up).
Ohinmaa et al., 200221	RCT	Remote primary care joint telemedicine (GP assisted) vs. F2F	145	General orthopaedic pathology	Cost effectiveness	Telemedicine cost effective, saved €2620 at a workload of 100 patients. Minimum 80 patients needed for societal cost saving.
Harno et al, 2001 [25]	Cohort	Remote primary care joint telemedicine (GP assisted) vs. F2F	194	General orthopaedic pathology	Clinician satisfaction	Feasibility of telemedicine as rated by clinicians was ‘excellent’ or ‘good’ in 49% of consultations. Confidence of specialists in telemedicine replacing F2F was low in 89% of specialists.
					Cost effectiveness	45% greater cost for F2F appointments compared with telemedicine. Higher cost due to hospital service charges.
Haukipuro et al., 200022	RCT	Primary care joint telemedicine (GP assisted) vs. F2F	145	General orthopaedic pathology including trauma	Clinician & patient satisfaction	Clinicians rated overall success of teleconsultation as ‘good’ or ‘very good’ in 80% compared with 99% in F2F (p<0.001). No significant difference in patient satisfaction (p>0.05); 97% of teleconsultation patients wanted to use this method for their next visit (with reasons including ease of visit, time saving and no travel).
Tachakra et al., 200031	Cross-sectional	Minor injuries unit joint telemedicine (nurse assisted) vs. F2F at same location	200	Minor injuries	Accuracy & validity of clinical examination	Telemedicine accuracy in assessment of colour change 97%, swelling or deformity 98%, ROM 95%, tenderness 97%, weight bearing 99% compared with F2F assessment. Treatment over prescribed in one case and under prescribed in three cases.
Aarnio et al., 199932	Cross-sectional	Remote hospital joint telemedicine (surgeon assisted) vs. F2F	29	General orthopaedic pathology	Clinician & patient satisfaction	87% of patients rated the teleconsultation as ‘good’ or ‘very good’. Consultants felt teleconsultation showed the exam ‘well’ or ‘very well’ 84% of cases. The ability to make decisions was ‘good’ or ‘very good’ in 93%.
Lambrecht et al., 199834	Case series	Remote hospital telemedicine	91	General trauma	Clinician satisfaction	All consultations were rated as ‘satisfactory’ or ‘excellent’.
					Patient safety & outcomes	No adverse patient outcomes during monitoring but unclear follow-up time.