To establish whether postoperative x-rays were of sufficient quality compared to those at the first outpatients’ appointment, uncomplicated primary total knee replacements performed by one surgeon were reviewed retrospectively. Measurements were made from these X-rays. Rotation was also assessed.

Forty-eight knee replacements were reviewed. Postoperative films showed the tibial tray to be tilted an average of 5. 04 degrees and a femoral valgus angle of 1. 56 degrees. First outpatients’ X-rays showed the tibial tray to be tilted an average of 1. 16 degrees and the femoral valgus angle to be an average 5. 16 degrees. 15 of 25 postoperative films were found to be rotated compared to 1 of 25 in the outpatients’ group.

Immediate postoperative films are of variable and often poor quality. Films at the first outpatients’ appointment were of superior quality.