Recent research suggests routine follow-up appointments after hip or knee replacement surgery might be unnecessary. Eliminating them could save millions of pounds and free up more time to treat those in need.
Here, we look at the recent study and when a follow-up might be required after a knee replacement procedure.
Why are follow-ups currently provided?
Joint replacement surgery can enhance a patient’s mobility and overall quality of life. However, in rare cases, they may encounter postoperative complications such as increased pain or difficulty performing everyday tasks. These complications may indicate a problem with the joint replacement, such as dislocation or bone fracture.
To detect issues early, follow-up appointments are recommended. However, providing follow-ups to all patients can be costly, so researchers wanted to establish if they were required in all cases.
What the new knee replacement research reveals
After analysing national datasets that included over 350,000 individuals, it was found that only a tiny percentage of knee replacements (5%) and hip replacements (3-6%) required revision. Another analysis of primary care data on 10,000 individuals with replacement joints indicated that those who attended routine follow-up appointments were more likely to have revision surgery compared to those who did not attend any follow-up appointments.
A panel of surgeons, general practitioners, and patients was consulted to explore these findings further. They recommended that patients who underwent straightforward surgery and received a National Institute for Health and Care Excellence (NICE)-recommended joint, routine follow-up appointments are unnecessary during the 1- to 10-year period after the procedure.
After ten years, patients should undergo X-rays to assess the joint alongside a clinical assessment that includes questionnaires on pain and mobility. The results of the 10-year assessment should then influence the frequency of future follow-up appointments.
When should a follow-up be provided?
According to the latest study, most patients who undergo joint replacement surgery may not require follow-up appointments during the 1- to 10-year period.
However, it should be noted that up to half of the joint replacements used in surgery are not recommended by UK guidance, potentially due to the surgeon’s preference. The recommendations provided by the researchers are only applicable to joint replacements recommended in the National Institute for Health and Care Excellence (NICE) guidance.
The researchers suggest that patients with worsening pain or other warning signs, such as difficulties with walking, should undergo follow-up appointments. The surgeon will better understand whether a follow-up appointment will likely be needed.
If you are due to undergo a knee replacement, you can discuss the likelihood of developing complications after the surgery with your knee surgeon. They can give you a better idea of whether a follow-up will be required after the procedure.