Is there any evidence to suggest that having check X-rays after THR/TKR is
necessary and whether doing them in the immediate postop period
significantly affects patient management or outcome?
We are routinely getting patients out of bed and starting mobilisation on
postop day 1 or 2 [depending on patients' fitness] irrespective of whether
they have had an X-ray and then plan transfer to our off-site rehab unit on
post-op day 3. There are exceptions when the surgeon may consider that
there may be a problem, eg femoral crack after THR. However, this has
usually been catered for by a planned period of reduced weightbearing being
decided at the time of the op, and very rarely altered by the outcome of
the check X-ray.
Getting the check X-ray done at our unit is quite laborious. This consists
of a transfer from bed to trolley to go to the X-ray Dept, go back to the
ward on the trolley, and then retransfer from trolley to bed - usually
done on postop day 2, provided the SHO has remembered to do the X-ray
form! Very few of the patients admit to enjoying the experience
Would not the 6 week review not be early enough?
What is done elsewhere? I would be interested in overseas as well as UK
practice.
Lee et al in Am J Phys Med Rehabil 2001;80:276-279 makes interesting
reading!
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