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 u23,297. 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.