Recovery Room Radiographs After Total Hip Arthroplasty

Ndu, Anthony; Jegede, Kolawole A.; Bohl, Daniel D.; Keggi, Kristaps J.; Grauer, Jonathan N.

doi:10.1016/j.arth.2011.12.020

Cited by 18 publications

(17 citation statements)

References 2 publications

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“…Similar to our study, none of the cases in the TKA series were adversely affected by delaying the initial postoperative radiographs, although some patients did experience complications after surgery [4,8,12,15]. Studies in the THA literature similarly mirror our findings [9,10,15]. Mulhall et al found a 0.1% rate of radiologic diagnosis of dislocation among 2065 consecutive patients who had hip arthroplasties and noted that image quality of PACU radiographs was substantially inferior to that of radiographs taken in the radiology suite [9].…”

Section: Discussionsupporting

confidence: 78%

Immediate Postoperative Radiographs After Shoulder Arthroplasty Are Often Poor Quality and Do Not Alter Care

Namdari

Hsu

Baron

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background It is technically difficult to obtain highquality, postoperative shoulder radiographs immediately after surgery. Further, poor-quality radiographs may be unlikely to change clinical practice or improve patient outcomes. We therefore questioned the value of routine postoperative radiographs after shoulder arthroplasty. Questions/Purposes We asked whether (1) postanesthesia care unit (PACU) radiographs can reasonably serve as a baseline for future studies; and (2) routine PACU radiographs change clinical care. (3) We also determined the charges associated with routine PACU radiographs and formal radiographic interpretation of these images. Methods We retrospectively compared the radiographs of 283 patients who had shoulder arthroplasties (Group 1) who underwent PACU radiographs with those of 241 patients (Group 2) who had their first postoperative radiographs at a later date. Radiographs were compared for quality, ability to serve as a baseline, and their influence on clinical course. Orthopaedic evaluation of each radiograph and the radiographic report were compared and charges were analyzed.

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Section: Discussionsupporting

confidence: 78%

Immediate Postoperative Radiographs After Shoulder Arthroplasty Are Often Poor Quality and Do Not Alter Care

Namdari

Hsu

Baron

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Given the high volume, optimising investigation approaches may provide substantial cost savings even when the percentage of overall cost reduction is small. Recent studies have identi ed examples of ine cient routine investigations, including radiographs and blood tests, during post-arthroplasty care in tertiary centres in USA and in China (5)(6)(7)(8)(9)(10)(11). However, only one similar study has been conducted in Australia, investigating the utility of week-one radiographs postarthroplasty (4).…”

Section: Clinical Relevancementioning

confidence: 99%

Cost of investigations during the acute hospital stay following total hip or knee arthroplasty, by complication status

Cheng

Lewin

Churches

et al. 2020

Preprint

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Background: Total hip and total knee arthroplasties are among the most common types of surgery performed in Australia today and are effective treatments for severe osteoarthritis. However, the increasing financial burden on the health system owing to the increasing rates of surgery has led to a growing interest in improving the cost-effectiveness and safety of arthroplasty care. This study was designed to quantify the association between post-operative complications, a major cost driver, and the cost of investigations following total hip or knee arthroplasty.Methods: This is a prospective cohort study of consecutive patients undergoing primary total hip or knee arthroplasty at an Australian public hospital. We measured the number and cost of imaging and pathology tests performed during the acute hospital stay and used linear regression to quantify the association between complication status and investigation costs. Results: Five hundred patients were included in the analysis. On average, those with complications received more tests, and more expensive tests. The mean combined cost of imaging and pathology tests in patients with no complications was AU$ 187 (SD: 12.0). In comparison, patients with minor complications had a mean additional cost of AU$ 270 (SD: 31.0), and those with major complications had a mean additional cost of AU$ 493 (SD: 54.2) (p<0.001).Conclusions: In patients undergoing hip or knee arthroplasty, investigation costs are substantially greater in the presence of either minor or major complications. With growing volumes of total hip and total knee arthroplasties, a potential focus of future research could include optimising investigation practices for patients with and without complications.

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“…No studies have examined the utility of radiography in the PACU specifically after hand and upper-extremity procedures; however, studies have suggested that PACU radiography has little utility in other areas of orthopaedics. 2,3 Although our study did not ask respondents about their practices regarding postsplinting radiographs of minimally displaced fractures, it is worthwhile to note that there has been some recent investigation into this topic. Chaudhry et al 7 found that post-splinting radiographs of nondisplaced/minimally displaced fractures that do not undergo manipulation during or before immobilization do not have clinical utility but do increase costs, wait times, and radiation exposure.…”

Section: Percent Of Postoperative Visits For Asymptomatic Patients Wimentioning

confidence: 99%

Routine Imaging after Operatively Repaired Distal Radius and Scaphoid Fractures: A Survey of Hand Surgeons

et al. 2014

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).Imaging contributes substantially to the rising cost of health care. 1 Among surgical specialists, orthopaedic surgeons order a particularly high volume of imaging. Radiographic series are regularly taken during the initial evaluation of a patient, during preoperative planning, while the operation is under way, immediately after the operation, and at intervals throughout postoperative follow-up. In addition to the financial burden, imaging is associated with patient and staff time and exposure to radiation. AbstractBackground There is currently no standard of care for imaging after hand and upperextremity procedures, and current imaging practices have not been characterized. Questions/Purposes To characterize current imaging practices and to compare those practices to the best available evidence.Patients and Methods A survey was distributed to attending-level surgeons at a regional hand and upper-extremity surgery conference in the United States in 2013. 40 out of 75 surgeons completed the survey (53%).Results All results are presented for distal radius and scaphoid fractures, respectively. There was a high degree of variability between respondents in the number of radiographic series routinely ordered during follow-up of asymptomatic patients, with the number of series ranging from 1-6 and 1-6. On average, respondents did not order an excessive number of follow-up radiographs for asymptomatic patients, with means (AE standard deviations) of 2.6 AE 1.0 and 3.3 AE 1.2 radiographic series. Radiographic series were taken at only 74% and 81% of postoperative visits with asymptomatic patients. Only 10% and 8% of respondents felt it was acceptable medical practice to save costs by ordering postoperative radiographs only when patients are symptomatic.Conclusions Among a sample of 40 fellowship-trained hand surgeons, these findings demonstrate a high degree of variability in number of radiographs obtained after operative repair of distal radius and scaphoid fractures. On average, respondents were relatively efficient with respect to total number of postoperative radiographs ordered. Level of Evidence Diagnostic study, level IV.

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Recovery Room Radiographs After Total Hip Arthroplasty

Cited by 18 publications

References 2 publications

Immediate Postoperative Radiographs After Shoulder Arthroplasty Are Often Poor Quality and Do Not Alter Care

Immediate Postoperative Radiographs After Shoulder Arthroplasty Are Often Poor Quality and Do Not Alter Care

Cost of investigations during the acute hospital stay following total hip or knee arthroplasty, by complication status

Routine Imaging after Operatively Repaired Distal Radius and Scaphoid Fractures: A Survey of Hand Surgeons

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