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Identifying complications requiring re-operation following primary hip or knee arthroplasty: a consecutive series of 98 patients

Reynolds, Bill, Maister, Nick, Gill, Stephen D., Waring, Shaun, Schoch, Peter, Beattie, Sally, Thomson, Andrew and Page, Richard S. 2018, Identifying complications requiring re-operation following primary hip or knee arthroplasty: a consecutive series of 98 patients, BMC musculoskeletal disorders, vol. 19, no. 1, doi: 10.1186/s12891-018-2005-y.

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Title Identifying complications requiring re-operation following primary hip or knee arthroplasty: a consecutive series of 98 patients
Author(s) Reynolds, Bill
Maister, Nick
Gill, Stephen D.
Waring, Shaun
Schoch, Peter
Beattie, Sally
Thomson, Andrew
Page, Richard S.ORCID iD for Page, Richard S. orcid.org/0000-0002-2225-7144
Journal name BMC musculoskeletal disorders
Volume number 19
Issue number 1
Article ID 91
Total pages 7
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2018-03-27
ISSN 1471-2474
Keyword(s) Arthroplasty
Complications
Hip
Knee
Revision surgery
Science & Technology
Life Sciences & Biomedicine
Orthopedics
Rheumatology
TOTAL JOINT ARTHROPLASTY
REPLACEMENT
SYSTEM
Summary Background
The number of hip and knee arthroplasties completed is expected to double over the next decade. In public hospitals, regular post-arthroplasty orthopaedic review has commonly occurred for the duration of a patient’s life, which requires substantial outpatient resources. However, there is limited evidence regarding the utility of these reviews for identifying complications. The current study investigated when and where complications requiring re-operation were identified following primary hip or knee arthroplasty.

Methods
The medical records of all patients requiring re-operation for complications following primary hip arthroplasty (n = 48, 2004 to 2015) or knee primary arthroplasty (n = 50, 1998 to 2015) at a large regional health service were evaluated. Data were extracted by one of four investigators using a standardised electronic data extraction tool. Variables of interest included the health setting where the complication was initially identified, how long following the original operation the complication was identified and whether the complication was symptomatic.

Results
Routine post-arthroplasty orthopaedic appointments identified 15 (15.3%) complications requiring re-operation; all were identified in the first-year post-surgery. For each complication identified in the first-year post-surgery, approximately 1000 orthopaedic outpatient appointments were required. After the first year, all complications were identified in Emergency Departments (n = 30, 30.6%), General Practice (n = 24, 24.5%) or non-routine orthopaedic outpatient appointments (n = 19, 19.4%). All patients with complications reported symptoms.

Conclusions
Routine post-arthroplasty review appointments were an inefficient mechanism for identifying complications requiring re-operation more than one year following surgery. Public health services should consider assessing and redesigning post-arthroplasty review services to reduce the burden on patients and the demand for outpatient appointments.
Language eng
DOI 10.1186/s12891-018-2005-y
Field of Research 1103 Clinical Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2018, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30107111

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.