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J Orthop. 2013 Jul 30;10(3):115-8. doi: 10.1016/j.jor.2013.07.004. eCollection 2013.

Utility of week one radiographs post total hip arthroplasty.

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Department of Orthopaedics, St. Vincent's Hospital Melbourne, VIC, Australia.
Department of Medical Imaging, St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia.



We retrospectively analysed 129 consecutive patients who underwent hip arthroplasty at a university-affiliated hospital in Melbourne, Australia between February and September 2011 with respect to the quality of the week one radiographs, placement of the prosthesis and the presence of a peri-prosthetic fracture or dislocation.


Patient records and radiographs were reviewed to ascertain whether a deviation in routine management occurred based on the information obtained from week one post-operative radiographs.


116 of the 129 patients met the inclusion criteria for the study. 115 patients underwent routine week one hip radiographs with a mean time after surgery of 2.5 days. 89 (77%) of these patients had radiographs with a typical post-operative appearance. 26 (23%) had radiographs with an atypical appearance defined by the presence of one or more of the following: offset difference of >10 mm (11%), leg length difference of >10 mm (11%), sub-optimal acetabular component inclination of <30° or >50° (9%), sub-optimal femoral stem position of >5° varus or valgus (2%), sub-optimal femoral Greun cement distribution of 2 or more absent zones (2%), cement extrusion (1%), peri-prosthetic fracture (0) or dislocation (0). None of the routine week one radiographs resulted in a change in early post-operative management. 1 patient underwent non-routine, immediate post-operative radiographs.


Our study did not demonstrate a case where deviation from standard clinical pathways occurred as a result of routine post-operative radiographs. A higher power study would help the established surgeon to determine whether post-operative radiographs could be performed at a more comfortable and convenient time such as the outpatient setting.


Arthroplasty; Hip; Orthopaedic surgery; Other categories; Radiograph

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