pre-discharge postoperative radiographs after primary total knee replacement: tradition or science?

ABSTRACT Background and purpose: There is mounting evidence questioning the utility of immediate postoperative radiographs after  total knee replacement (TKR). We hypothesized that eliminating the pre-discharge film would not have any effect on the postoperative patient outcomes. Materials and Methods: Retrospective analysis of prospectively collected data was performed on 220 knees from January 2013 to July 2015. Group1- Surgeon A, 112 knees with pre-discharge radiographs and group2- Surgeon B, 108 knees with weight bearing radiographs 6 weeks postoperatively. Results: Greater knee pain was seen in Group 1 (p = 0.01). A cost reduction of approximately $220 per patient was observed with the exclusion of the pre-discharge film. Eliminating routine inpatient pre-discharge radiographs after simple primary TKR does not alter the rehabilitation protocol, identify any of the standard complication or have any medico-legal implications. On the contrary, these films seem to increase postoperative pain and costs.