Use radiography rarely, not routinely, for hip hemiarthroplasty

Area of Science:

• Orthopedic Surgery
• Radiology
• Health Economics

Background:

• Hip hemiarthroplasty (HA) is a frequent surgical procedure for hip fractures.
• Post-operative radiographs are standard in hip fracture care, often taken after patient mobilization.

Purpose of the Study:

• To evaluate the clinical utility of routine post-operative radiographs following HA.
• To inform evidence-based changes for patient safety and resource allocation in the NHS.

Main Methods:

• Retrospective review of 1563 HA procedures.
• Analysis of the role of check radiographs in post-operative patient management.

Main Results:

• Only 0.2% of post-operative radiographs uniquely identified complications (dislocations).
• 1.2% of patients experienced mechanical complications (dislocations) requiring reoperation within 6 weeks.
• Most dislocations were suspected or identified prior to radiography.

Conclusions:

• Routine post-operative radiography after HA provides minimal clinical benefit for most patients.
• This practice poses risks and incurs costs for the NHS.
• Intra-operative fluoroscopic imaging is proposed as a pragmatic alternative.