INTERPRETATION BY RADIOLOGISTS OF ORTHOPEDIC TOTAL JOINT RADIOGRAPHS - IS IT NECESSARY OR COST-EFFECTIVE

OBJECTIVE: TO examine the necessity and cost-effectiveness of interpre tation by radiologists of orthopedic radiographs obtained for patients who undergo total hip or knee replacement. DESIGN: A prospective stud y. Serial preoperative and postoperative x-ray films of the joint in p atients scheduled to undergo total hip or knee joint replacement durin g one calendar year were interpreted by both radiology and orthopedic department staff and compared. Intraoperative findings were used to co nfirm the radiologic interpretation. The follow-up was 1 year. SETTING : A university teaching hospital. INTERVENTIONS: Primary or revision t ot-al hip or knee replacement. MAIN OUTCOME MEASURES: Differences in i nterpretation bf radiographs by radiologists and orthopedic surgeons f or any of the four procedures. A change in orthopedic management. RESU LTS: For preoperative radiographs, there were no discrepancies between the radiologists and orthopedic surgeons with respect to primary join t replacement. For 100 revision procedures there were 15 discrepancies , but in all cases the orthopedic surgeon's interpretation proved to b e correct. For the postoperative radiographs, there were no discrepanc ies in the group of revision hip replacements. For the other three gro ups there were a total of six discrepancies and in all cases the ortho pedic surgeon's interpretation was correct. In two cases conditions we re present that were nor recognized by staff from either the radiology department or orthopedic department. CONCLUSION: Interpretation by ra diologists of total joint radiographs in patients who undergo primary or revision total hip or knee replacement arthroplasty is not necessar y or cost-effective.