Do Routine Radiographs Obtained at Initial Outpatient Postoperative Visit Change Management?

Area of Science:

• Orthopaedic Surgery
• Radiology
• Health Economics

Background:

• Postoperative radiographs are standard practice in orthopaedic surgery.
• The necessity and impact of these routine imaging studies are often debated.

Purpose of the Study:

• To evaluate the clinical utility of routine postoperative radiographs.
• To quantify the associated radiation exposure and healthcare costs.

Main Methods:

• Retrospective analysis of orthopaedic surgeries at a level I trauma center in 2007.
• Included procedures likely to require follow-up radiographs.
• Assessed changes in management based on radiographic findings.

Main Results:

• 54% of analyzed procedures received initial postoperative radiographs.
• Only 0.879% of routine radiographs led to a change in management.
• Nonroutine radiographs had a 12.5% rate of changing management.
• Mean radiation exposure was 0.199 mSv per procedure.
• Median cost was $29.98 per radiographic series.

Conclusions:

• Routine postoperative radiographs in orthopaedic surgery have limited clinical utility.
• The current practice leads to unnecessary radiation exposure and healthcare expenditure.
• Consideration should be given to selective use of postoperative imaging based on clinical indication.