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Background: Utilizing conversational analytics in orthopaedic surgery may provide insights into patients’ experiences and outcomes. This study retrospectively assessed how patients interacted with a perioperative chatbot and whether the topic of patients’ queries could offer insight on their outcomes after total knee or hip arthroplasty. Methods: We identified 1338 patients (746 knees and 592 hips) who enrolled in a short message service chatbot from 2020-2022 with greater than 3 months of follow-up. The total number and topics of patient-generated text responses to the chatbot were recorded. Independent t-tests, chi-squared tests, and linear regressions were performed to determine if specific patient-generated responses to the chatbot or overall chatbot engagement were associated with demographics or outcomes. Results: Readmitted patients interacted less with the perioperative chatbot than those who were not readmitted (3.9 messages vs 12.7 messages, P < .0001). Return to emergency department (ED) and reoperation rates were not associated with engagement. Patients who visited the ED within 90 days of their surgery were most commonly seeking advice about walking after surgery (P = .0046) and weaning off their opiate pain medications (P = .0281). Patients who were readmitted to the hospital were similarly seeking advice about walking (P = .0188) and weaning off pain medications (P = .0218). Replying “exercise” was associated with no ED visits or readmissions (P = .0009). Patients with a mental health diagnosis were more likely to reply with high-acuity topics (P = .0052). Conclusions: The topic of chatbot queries and chatbot engagement were associated with patient outcomes after total knee arthroplasty or total hip arthroplasty and may provide insight to patients’ perioperative courses.

Orthopedic clinics are becoming strained with clinical volume outpacing resources and personnel. Patient engagement platforms can help bridge the communication and engagement gaps between patients and their healthcare teams as total hip and knee arthroplasty transitions to the outpatient setting. These platforms provide a digital infrastructure that allows patients to participate in their healthcare journey while alleviating the burdens on clinic staff. Multiple forms of patient engagement platforms exist but typically fall into one of 3 groups: patient portals, mobile health applications, and chatbots. They all play an important role in enhancing postoperative rehabilitation, patient engagement, and patient care overall. This article explores the spectrum of available patient engagement platforms and examines their advantages, limitations, and documented benefits on clinical outcomes.