Is there a need for early post-operative x-rays in primary total knee replacements? Experience of a centre in the UK

Abstract

Introduction: Early post-operative x-rays are often taken in total knee replacements (TKRs). Patient mobilisation may be delayed until these x-rays are obtained and this may prolong discharge. The aim of this study was to assess the value of such early x-rays and whether they influenced the early post-operative management of these patients.

Methods: A total of 624 consecutive TKRs performed at the Blackpool Victoria Hospital over a 34-month period were evaluated. Plain anteroposterior and lateral x-rays were examined.

Results: Two patients were found to have significant abnormalities: an undisplaced periprosthetic tibial fracture and a partial inferior pole patellar avulsion. Neither of these required further treatment or influenced mobility. No other complications were noted that changed routine post-operative management.

Conclusions: These results question the need for immediate x-rays in primary TKRs.

Figures

Figure 1

Case 1: pre-operative x-ray showing no tibial fracture (A) and post-operative x-ray showing an undisplaced periprosthetic tibial fracture (B)

Figure 2

Case 2: immediate post-operative lateral x-ray showing patellar avulsion fracture