Hip arthroplasty: the role of plain radiographs in outpatient management

Abstract

Purpose: To determine whether findings on plain radiographs alter clinical care in outpatient management after hip arthroplasty.

Materials and methods: From June 1, 1993, through February 28, 1994, one arthroplasty surgeon saw 148 outpatients (age range, 15-86 years) after hip arthroplasty (163 prostheses). The surgeon made decisions about clinical management before he reviewed the plain hip radiographs. After he reviewed the radiographs, he recorded any changes in the management plan.

Results: In only one case did the radiographic findings change patient treatment. The prosthesis in this relatively asymptomatic patient had been in place for over 9 years and appeared clinically to be functioning well, but radiographs demonstrated aggressive granulomatosis. Therefore, the patient underwent revision arthroplasty. In the remaining 147 patients, radiographic findings had no impact on clinical management.

Conclusion: Radiographic evaluation may be most beneficial in patients with hip prostheses that have been in place for many years to rule out asymptomatic bone loss due to aggressive granulomatosis.