Abstract
Introduction: Hip arthroplasty represents a large consumer of resources in orthopaedic surgery. Although the need for follow up is universally accepted, there is much debate on the duration and frequency of outpatient visits. To date there is no evidence regarding the cost effectiveness of follow up.
There are no NICE guidelines for hip arthroplasty follow up. 90% of hip arthroplasty failures do so after 5 years. Joint replacement review is performed by a variety of personnel including orthopaedic surgeons, surgical care practitioners (SCPs) and extended scope practitioners (ESPs). Patients are reviewed in an outpatient clinic or by questionnaire.
Methods: A questionnaire was sent out to orthopaedic surgeons working in the Sandwell and West Birmingham Hospitals Trust enquiring about their practice for following up patients who have had hip replacements. Information regarding the length of follow up, frequency of visits and the use of check radiographs was recorded.
Results: The mean length of follow up was 28.8 months. (12–60 months). The mean number of visits in the first year was 3.9. (3–4). The mean number of total visits was 6. (4–9). The mean number of check radiographs performed in the first year was 2. Mean total number of check radiographs performed was 4. The mean cost for each patient is 590 pounds. (224–896 pounds).
Discussion: There is considerable variation in hip arthroplasty follow up with ensuing cost implications.
Guidance is required for the appropriate review, which will allow early detection of complications in an efficient and cost effective manner.
In our trust a protocol has been suggested for the follow up of hip arthroplasty by ESPs and SCPs.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
