Patients will usually be seen for their first follow-up appointment at around six weeks following surgery. At that stage progress will be reviewed and physiotherapy, if required, will be arranged. It is usually not necessary to have x-rays at that stage unless there are any particular concerns.
Patients will typically then be seen at three months post-operation. Some patients who have had hip resurfacing or uncemented implants may well require x-rays at that stage and further x-rays at six months.
In patients who have had cemented implants or hybrid implants, I would plan to review progress at around a year from the procedure with an x-ray on arrival.
The x-ray is performed to ensure that the components are all solidly fixed and secure and that the alignment is satisfactory. With hybrid hip replacements there is usually then no need for any further x-rays for a number of years.
With regard to long term follow-up, I think it is important that joint replacements are followed up. Typically patients will be reviewed over time with x-rays as required. It is important to ensure there is no undue wear on the implant. Unfortunately sometimes wear can occur in the absence of symptoms and for that reason x-ray can be important. Scoring systems can be used to assess how patients are progressing. The patient’s function and activity profile can be discussed and obviously it is important for patients to be in a position to ask any questions about how things are progressing.
For that reason my protocol is to follow-up patients at a year and two years post-surgery then normally at five to six years after the procedure and again at ten years with an x-ray on arrival to ensure that all is progressing well.
Hip resurfacing patients and patients with high demand bearings or uncemented implants are followed up slightly more frequently.
© Andrew R J Manktelow – September 2011