An audit of the out-patient follow-up of hip and knee replacements.
Medical records of 100 consecutive patients who underwent hip and knee replacements (56 hips and 44 knees) in 1997-1998 were studied. Particular attention was paid to the out-patient follow-up appointments with regard to any postoperative complication and intervention based on the clinical and radiological assessment conducted during the follow-up visit. The average period of follow-up was 845 days. During this period, these patients had 304 out-patient visits. Twenty-two patients had a problem during this period of whom 10 needed an intervention. Of the 10 patients who needed an intervention, 3 were identified during the routine out-patient visits whereas 7 were either by general practitioner referral or were seen in the accident and emergency department. At these appointments, 187 radiographs were taken. Of these, 8 (4.3%) showed some abnormality. The minimum cost for these follow-up appointments was estimated to be 23,297 pounds sterling. We recommend that the postoperative out-patient appointment of the patients with hip and knee replacements should be restricted to a visit at 6-12 weeks followed by discharge if no problems are anticipated.
Bhatia
M
M
Department of Trauma & Orthopaedics, West Cumberland Hospital, Whitehaven, Cumbria, UK. maneeshB@aol.com
Obadare
Z
Z
D000553:Ambulatory Care / Q000191:economics; D019644:Arthroplasty, Replacement, Hip / Q000191:economics* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005500:Follow-Up Studies; D006801:Humans; D008485:Medical Audit