Abstract
Background
There is a longstanding culture of repeat x-rays after total knee replacement (TKR) as part of follow up, often combined with a clinic review. This is to check that the prosthesis is in a satisfactory position. There are inherently a number of issues with this historic approach including exposure of patients to further radiation who may be asymptomatic, time delays in busy clinics or x-ray departments and costs.
Objectives
The aim of this audit was to assess whether follow up plain films after TKR are methodically undertaken and of benefit to confirm satisfactory appearance if immediate post -operative x-rays were unremarkable. The findings of a six month follow up x-ray was specifically evaluated. The secondary aim was to establish the timing of further follow up x-rays within the department.
Method
200 patients were included within the analysis, they all received a TKR at a major trauma centre, over a one-year period between December 2017 and December 2018.
Results
It was found that 100% of those patients having a post-operative film had a satisfactory appearance. 78% of patients had at least one further follow op x-ray of which 99.4% were satisfactory. Up to five follow up x-rays were taken with 53.5% of patients having a follow up x-ray at 6 months.
Conclusions
From the above results there is minimal, if any, evidence within the data set to support routine, additional follow up imaging if initial post-operative films are satisfactory, and the patient is asymptomatic.
Patient satisfaction at 2 months following total knee replacement using a second generation medial-pivot system: follow-up of 250 consecutive cases
