Aims: Post-operative check radiographs after primary total hip replacement are routine practice in many orthopaedic units. However they can be uncomfortable for patients and are often of poor quality. We conducted a prospective study to assess the quality of post-operative check radiographs after total hip replacement and to establish whether they alter the management of the patient.

Patients and method: We included 50 consecutive patients that underwent a primary total hip replacement in our study. During the post-operative period A-P and lateral check radiographs of the hip were performed. For each patient, any change in management and the time to discharge were recorded. The quality of each set of radiographs was assessed using a standard proforma (0–10) and scored by two independent observers.

Results: The mean age of the patients was 68 years (range 39 to 83 years). The median time to x-ray was 4.0 days from operation and the median length of stay was 7.0 days. Overall 7 (14%) patients had their discharge delayed by a mean time of 2.0 (±0.89) days waiting for post-operative radiographs. The mean score for quality of radiographs was 8.12 (±1.32) with good inter-observer and intra-observer agreement. In total, 15 (30%) sets of radiographs were of inferior quality (a score of 7 or less). None of the patients had their management altered by the post-operative radiographs.

Conclusion: We conclude that initial post-operative radiographs are of inferior quality and do not alter the management of the patient. Consideration should be given to performing check radiographs at the first out-patient clinic follow-up as an alternative.