title: Postoperative radiographs after ACL reconstruction are not cost-effective.
abstract: Postoperative radiographs have become standard after anterior cruciate ligament (ACL) reconstruction, even though few findings in the literature substantiate their efficacy. The goal of this study was to determine whether routine postoperative radiographs were cost-effective in patients undergoing ACL reconstruction. In addition, the authors sought to determine whether these radiographs provided meaningful clinical information that changed postoperative management. Between January and December 2010, the authors retrospectively reviewed all patients who underwent ACL reconstruction at their institution. The clinical course of all patients was reviewed to determine whether the results of the radiograph at the time of interpretation changed the plan of care. All radiographs were then scrutinized for abnormal findings that could have changed the plan of care if noted at the time of follow-up. Of 624 patients who underwent ACL reconstruction, 340 (54.4%) had a postoperative radiograph within 30 days. No radiograph showed a complication as interpreted by the surgeon at the time the radiograph was obtained, and no changes were made in routine postoperative care. On final review of each radiograph, none showed findings that would have changed management. The cost of performing and interpreting radiographs was $42.62 per patient, with a combined cost of $14,490.80. The findings of the study showed that postoperative radiographs after ACL reconstruction should not be considered "routine" practice. In addition, because these studies provided little clinical information, they are recommended only when symptoms suggest a mechanical complication and in cases of unforeseen postoperative trauma.
authors.forename: Charlton
authors.initials: C
authors.lastname: Stucken
authors.forename: Russell
authors.initials: R
authors.lastname: Flato
authors.forename: Thomas
authors.initials: T
authors.lastname: O'Hagan
authors.forename: Daniel
authors.initials: D
authors.lastname: O'Brien
authors.forename: Devin
authors.initials: D
authors.lastname: Ruiz
authors.forename: Steven B
authors.initials: SB
authors.lastname: Cohen
authors.forename: Christopher
authors.initials: C
authors.lastname: Dodson
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ciccotti
authors.forename: Fotios
authors.initials: F
authors.lastname: Tjoumakaris
mesh_terms: D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging* / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000191:economics*; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D011182:Postoperative Care / Q000191:economics*; D011184:Postoperative Period; D011859:Radiography; D012189:Retrospective Studies