In an ideal world it would be appropriate to follow-up all major joint replacement
procedures for life (like MOT for our cars). However, it takes significant resources
from the health system including the cost, number of man hours as well the inconvenience
faced by the patients in making their follow-up trips when they are completely asymptomatic.
But at the same time, if the patients are not followed up regularly, silent problems
like implant loosening, impending peri-prosthetic fracture etc., may not be picked
up early and when they become symptomatic, the bone loss may be severe requiring
more complex surgery. To avoid such a situation some form of follow-up is required.
Studies have shown that if after the initial year or two, the patients could be followed
up by validated outcome score questionnaires and radiological investigations at appropriate
time intervals which could be reviewed by their surgeons without having to see the
patients personally in the clinics. Patients could be called back for review if problems
are identified. Hopefully this system of follow-up will also be adopted in our part
of the world in the near future! It is likely that you will be sent forms to fill
Oxford Hip score and Oxford Knee score are two of the commonly used patient reported
outcome scores following hip and knee replacements - they are simple to use and have
been validated. However, in young and active patients the scoring systems reach a
ceiling effect (i.e. most of the patients score very well but it does not differentiate
“very good” from “good”). Most of the scoring systems give predominance to pain relief
and less importance to activity levels which many of the young and active patients
consider important to regain in addition to the pain relief following a joint replacement.
UCLA score is a validated scoring system for hip replacement outcome in younger adults
as the Oxford hip scores probably reach a ceiling effect in many younger patients.
In addition to postoperative follow-up, it would also be appropriate to fill the
outcome scores which would give an indication of the pre-operative functional status.
Please feel free to download and print the forms (which are in PDF format). You can
can complete them and take it along with you when you see Mr.Ganapathi for consultation.