Comparison of Radiographic Quality of Immediate Postoperative Imaging Performed in Operating Room versus In Post-anesthesia Care Unit: A Retrospective Study
2Orthopedic Surgery, Wolfson Medical Center, Israel
Background:
Performed immediately after the surgery in the operating room (OR) or in post-anesthesia care unit (PACU), first postoperative radiographs are often characterized by low quality. To the best of our knowledge there are no clear guidelines regarding setting of postoperative imaging following total hip arthroplasty (THA). Our study sought to determine whether there is a preferred setting for the postoperative radiographs, that provides technically optimal, high-quality result.
Study Design:
A retrospective analysis of technical quality of postoperative radiographs performed after primary THAs in Rabin Medical Center between February 2017 and May 2020. We evaluated the anteroposterior (AP) pelvis radiographs in terms of technical quality and clinical significance (the number of revisions performed based only on first postoperative X-ray).
Results:
We evaluated 267 postoperative radiographs (139 performed in PACU and 128 in OR) of patients who underwent primary unilateral THA. There were no revisions performed, based only on postoperative radiographs. In terms of technical quality, PACU X-rays were characterised by better penetration (69.1% vs 27.3%, p<0.001) and less foreign bodies in the field (95.7% vs 83.6%, p<0.001), but less adequate collimation (41.7% vs 79.7%, p<0.001). In terms of orthogonality there was no significant difference between two groups, but there was a significant difference in number of “perfect” radiographs (X-rays performed without any significant technical errors) – 17.3% in PACU group vs 7.8% in OR group. (p=0.021)
Conclusion:
Although the overall number of “perfect” radiographs was low in both groups, the postoperative X-rays performed in PACU were characterized by better technical quality compared to postoperative X-rays performed in OR. In the meantime, the clinical significance of immediate postoperative radiographs in uncomplicated primary surgery remains unclear.