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.
Subject(s)
Aftercare/standards , Arthroplasty, Replacement, Hip , Hip Joint/diagnostic imaging , Adult , Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Hip/methods , Denmark , Female , Hip Prosthesis/adverse effects , Humans , Male , Middle Aged , Practice Guidelines as Topic , Radiography/statistics & numerical data , Retrospective StudiesABSTRACT
BACKGROUND: Knee arthrodesis with external fixation (XF) is a possible salvage procedure for infected total knee arthroplasties (TKA). We report the outcome in 10 patients who underwent arthrodesis with the Sheffield Ring Fixator. PATIENTS AND METHODS: The patients had primary arthrosis in 8 cases; 2 cases were due to rheumatoid arthritis and sclerodermia. The mean time between the primary TKA and arthrodesis was 6 (0.5-14) years. The average age at arthrodesis was 69 years. The average follow-up period was 10 months. RESULTS: Stable fusion was obtained in 6 patients after a mean XF time of 3.6 (2-4) months. 1 patient was referred to another hospital because of nonunion. This patient showed fusion with intramedullary nailing after 7 months. 3 nonunion patients required permanent bracing. 7 patients had pin tract infections. Infections healed in all patients. INTERPRETATION: The Sheffield Ring Fixator gives an acceptable fusion rate for arthrodesis in the infected TKA, with limited complications.
