Is there a need for routine follow-up after primary total hip arthroplasty?

Hacking, Craig, Weinrauch, Patrick C., Whitehouse, Sarah L., Crawford, Ross W., & Donnelly, William J. (2010) Is there a need for routine follow-up after primary total hip arthroplasty? ANZ Journal of Surgery, 80(10), pp. 737-740.

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Background: The objective of routine outpatient assessment of well functioning patients after primary total hip arthroplasty (THA) is to detect asymptomatic failure of prostheses to guide recommendations for early intervention. We have observed that the revision of THAs in asymptomatic patients is highly uncommon. We therefore question the need for routine follow-up of patients after THA.

Methods: A prospective analysis of an orthopaedic database identified 158 patients who received 177 revision THAs over a 4 year period. A retrospective chart review was conducted. Patient demographics, primary and revision surgery parameters and follow-up information was recorded and cross referenced with AOA NJRR data.

Results: 110 THAs in 104 patients (average age 70.4 (SD 9.8 years). There were 70 (63.6%) total, 13 (11.8%) femoral and 27 (24.5%) acetabular revisions. The indications for revision were aseptic loosening (70%), dislocation (8.2%), peri-prosthetic fracture (7.3%), osteolysis (6.4%) and infection (4.5%). Only 4 (3.6%) were asymptomatic revisions. A mean of 5.3 (SD 5.2 and 1.9 (SD 5.3 follow-up appointments were required before revision in patients with and without symptoms, respectively. The average time from the primary to revision surgery was 11.8 (SD 7.23) years.

Conclusions: We conclude that patients with prostheses with excellent long term clinical results as validated by Joint Registries, routine follow-up of asymptomatic THA should be questioned and requires further investigation. Based on the work of this study, the current practice of routine follow-up of asymptomatic THA may be excessively costly and unnecessary and a less resource-intensive review method may be more appropriate.

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7 citations in Scopus
6 citations in Web of Science®
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ID Code: 33276
Item Type: Journal Article
Refereed: Yes
Keywords: asymptomatic revision, routine follow-up, total hip arthroplasty
DOI: 10.1111/j.1445-2197.2010.05346.x
ISSN: 1445-2197
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Past > Schools > School of Engineering Systems
Copyright Owner: Copyright 2010 Wiley-Blackwell Publishing Asia
Copyright Statement: Journal compilation © 2010 Royal Australasian College of Surgeons
Deposited On: 28 Jul 2010 21:37
Last Modified: 29 Feb 2012 14:28

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