No clinical value of post-operative routine X-ray following uncomplicated cementless primary total hip arthroplasty

Abstract

Introduction: There is no consensus among hip surgeons in Denmark on how to follow up patients after total hip arthroplasty (THA). Agreement on the need for radiographic examinations is also lacking. The purpose of this study was to evaluate if routine outpatient post-operative radiographs, obtained three and 12 months after uncomplicated cementless primary THA influenced patient treatment.

Material and methods: A retrospective chart review was performed for 249 cases who had received THA during a four-month period. Patient data, indication for surgery and type of prosthesis were noted. The radiographic descriptions in the medical record made by the operating surgeon at the three- and 12-month outpatient follow-up visits were examined.

Results: At three months, the radiograph showed subsidence ranging from "barely detectable" to ten millimetres in eight of 216 cases. One patient was treated with crutches. The remaining three patients were given another follow-up visit. At 12 months, two cases had signs of stress shielding with cortical thickening. This had no consequence in one patient and the other was given additional follow-up.

Conclusion: We conclude that routine radiographs can be omitted from the outpatient follow-up within the first year following primary elective cementless THA as it does not affect treatment. We believe radiographs should be reserved for patients with subjective complaints such as pain and to those who are referred outside the routine follow-up plan due to complications.

Funding: not relevant.

Trial registration: not relevant.