Aj. Lee et al., Cost-effectiveness of screening x-rays at admission to acute rehabilitation after joint replacement surgery - A retrospective chart review, AM J PHYS M, 80(4), 2001, pp. 276-279
Citations number
8
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION
Objective: To investigate the cost-effectiveness of performing routine scre
ening x-rays for patients on admission to an acute rehabilitation facility,
after hip or knee replacement surgery, by reviewing the overall incidence
of abnormal radiographic findings and determining their impact on patient c
are and outcome.
Design: A retrospective chart review study, in which 592 patients were admi
tted, after hip or knee replacement surgery, to three acute inpatient rehab
ilitation facilities under one system.
Results: Eight of 592 admissions revealed abnormal screening x-rays, for an
overall incidence of 1.35%. All of the eight abnormal radiologic cases rem
ained medically stable throughout their acute rehabilitation stay. The abno
rmalities did not alter the patients' medical management or length of stay.
One case, which had demonstrated normal admission films, revealed a disloc
ated hip prosthesis on a follow-up x-ray, which was obtained as a result of
new onset hip pain. The patient was subsequently transferred back to the a
cute care hospital for surgical correction.
Conclusions: The authors found a relatively low incidence of abnormal admis
sion x-ray findings; furthermore, the detection of abnormal admission films
did not alter patient care or outcome. The results suggested that performi
ng routine admission radiologic studies on all patients after joint replace
ment surgery or hemiarthroplasty may not be a cost-effective screening tool
in rehabilitation.