Guidelines for the follow-up of total hip arthroplasty: do they need to be revised?

Bone Joint J. 2019 May;101-B(5):536-539. doi: 10.1302/0301-620X.101B5.BJJ-2018-0853.R2.

Abstract

Aims: The aim of this retrospective audit was to determine the route of referral or presentation of patients requiring revision following primary total hip arthroplasty (THA).

Patients and methods: A total of 4802 patients were implanted with an Orthopaedic Data Evaluation Panel (ODEP) 10A* cementless implant (Corail/Pinnacle) between 2005 and 2015; 80 patients with a mean age of 67.8 years (sd 10.8) underwent a subsequent revision. The primary outcome measure was route of referral for revision.

Results: Of the 80 revisions, 31 (38.8%) took place within the first year and 69 (86.3%) took place within six years. Only two of the 80 patients were picked up at a routine review clinic, one for infection and the other for liner dissociation. A total of 36 revised patients (45.0%) were reviewed following self-referral. Of the remaining 44 revised patients (55.0%), 15 (18.8%) were General Practitioner referrals, 13 (16.3%) were other hospital referrals, six (7.5%) were inpatients, six (7.5%) were Emergency Department referrals, and two (2.5%) were readmitted from their homes. No revisions were carried out on asymptomatic patients.

Conclusion: Our experience suggests that if there is a robust system in place for self-referral, patients with an ODEP 10A* hip implant can, if asymptomatic, be safely discharged at the time of their first postoperative review. Cite this article: Bone Joint J 2019;101-B:536-539.

Keywords: Hip arthroplasty; Long-term follow-up; Review.

MeSH terms

  • Aftercare / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Clinical Audit
  • Hip Prosthesis / adverse effects*
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • Practice Guidelines as Topic
  • Prosthesis Failure
  • Referral and Consultation / statistics & numerical data*
  • Reoperation / statistics & numerical data*
  • Retrospective Studies
  • Treatment Outcome